Conventional in-vitro fertilisation versus intracytoplasmic sperm injection for the treatment of non-male-factor infertility: a randomised controlled trial

Siladitya Bhattacharya, Margaret Hamilton, M. Shaaban, Y. Khalaf, M. Seddler, T. Ghobara, P. Braude, R. Kennedy, A. Rutherford, G. Hartshorne, Alexander Allan Templeton

Research output: Contribution to journalArticle

162 Citations (Scopus)

Abstract

Background Intracytoplasmic sperm injection (ICSI) is a more invasive option than conventional in-vitro fertilisation (IVF), which can be successful even when semen characteristics are poor. Reports of higher fertilisation rates after ICSI suggest that this technique may be better than the conventional method for all couples seeking IVF. We undertook multicentre randomised controlled trial comparing clinical outcome after ICSI or traditional IVF in couples with non-male-factor infertility. than IVF. conventional undertook.

Methods 415 eligible and consenting couples at four UK centres were randomly assigned IVF or ICSI (total 435 treatment cycles: IVF 224; ICSI 211). Usual clinical and laboratory protocols for the two treatment procedures were followed in each of four participating centres. The primary outcome was the implantation rate (number of gestation sacs per embryo replaced expressed as a percentage). Secondary outcomes were pregnancy and fertilisation rates associated with each treatment. Analyses were by intention to treat.

Findings The implantation rate was higher in the IVF group than in the ICSI group (95/318 [30%] vs 72/325 [22%]; relative risk 1.35 [95% CI 1.04-1.76]). The pregnancy rate per cycle was also higher after IVF (72 [33%] vs 53 [26%]; 1.17 [0.97-1.35]). Mean associated laboratory time was significantly shorter with IVF than with ICSI (22.9 [SD 12.1] vs 74.0 [38.1] min; 95% CI for difference 45.6-56.6).

Interpretation ICSI offers no advantage over IVF in terms of clinical outcome in cases of non-male-factor infertility. Our results support the current practice of reserving ICSI only for severe male-factor problems.

Original languageEnglish
Pages (from-to)2075-2079
Number of pages4
JournalThe Lancet
Volume357
Issue number9274
DOIs
Publication statusPublished - Jun 2001

Keywords

  • TUBAL FACTOR
  • FERTILIZATION
  • SEMEN
  • IMPLANTATION
  • PROGRAM
  • EMBRYOS
  • COUPLES
  • ICSI
  • AGE

Cite this

Conventional in-vitro fertilisation versus intracytoplasmic sperm injection for the treatment of non-male-factor infertility: a randomised controlled trial. / Bhattacharya, Siladitya; Hamilton, Margaret; Shaaban, M.; Khalaf, Y.; Seddler, M.; Ghobara, T.; Braude, P.; Kennedy, R.; Rutherford, A.; Hartshorne, G.; Templeton, Alexander Allan.

In: The Lancet, Vol. 357, No. 9274, 06.2001, p. 2075-2079.

Research output: Contribution to journalArticle

Bhattacharya, S, Hamilton, M, Shaaban, M, Khalaf, Y, Seddler, M, Ghobara, T, Braude, P, Kennedy, R, Rutherford, A, Hartshorne, G & Templeton, AA 2001, 'Conventional in-vitro fertilisation versus intracytoplasmic sperm injection for the treatment of non-male-factor infertility: a randomised controlled trial', The Lancet, vol. 357, no. 9274, pp. 2075-2079. https://doi.org/10.1016/S0140-6736(00)05179-5
Bhattacharya, Siladitya ; Hamilton, Margaret ; Shaaban, M. ; Khalaf, Y. ; Seddler, M. ; Ghobara, T. ; Braude, P. ; Kennedy, R. ; Rutherford, A. ; Hartshorne, G. ; Templeton, Alexander Allan. / Conventional in-vitro fertilisation versus intracytoplasmic sperm injection for the treatment of non-male-factor infertility: a randomised controlled trial. In: The Lancet. 2001 ; Vol. 357, No. 9274. pp. 2075-2079.
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abstract = "Background Intracytoplasmic sperm injection (ICSI) is a more invasive option than conventional in-vitro fertilisation (IVF), which can be successful even when semen characteristics are poor. Reports of higher fertilisation rates after ICSI suggest that this technique may be better than the conventional method for all couples seeking IVF. We undertook multicentre randomised controlled trial comparing clinical outcome after ICSI or traditional IVF in couples with non-male-factor infertility. than IVF. conventional undertook.Methods 415 eligible and consenting couples at four UK centres were randomly assigned IVF or ICSI (total 435 treatment cycles: IVF 224; ICSI 211). Usual clinical and laboratory protocols for the two treatment procedures were followed in each of four participating centres. The primary outcome was the implantation rate (number of gestation sacs per embryo replaced expressed as a percentage). Secondary outcomes were pregnancy and fertilisation rates associated with each treatment. Analyses were by intention to treat.Findings The implantation rate was higher in the IVF group than in the ICSI group (95/318 [30{\%}] vs 72/325 [22{\%}]; relative risk 1.35 [95{\%} CI 1.04-1.76]). The pregnancy rate per cycle was also higher after IVF (72 [33{\%}] vs 53 [26{\%}]; 1.17 [0.97-1.35]). Mean associated laboratory time was significantly shorter with IVF than with ICSI (22.9 [SD 12.1] vs 74.0 [38.1] min; 95{\%} CI for difference 45.6-56.6).Interpretation ICSI offers no advantage over IVF in terms of clinical outcome in cases of non-male-factor infertility. Our results support the current practice of reserving ICSI only for severe male-factor problems.",
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T1 - Conventional in-vitro fertilisation versus intracytoplasmic sperm injection for the treatment of non-male-factor infertility: a randomised controlled trial

AU - Bhattacharya, Siladitya

AU - Hamilton, Margaret

AU - Shaaban, M.

AU - Khalaf, Y.

AU - Seddler, M.

AU - Ghobara, T.

AU - Braude, P.

AU - Kennedy, R.

AU - Rutherford, A.

AU - Hartshorne, G.

AU - Templeton, Alexander Allan

PY - 2001/6

Y1 - 2001/6

N2 - Background Intracytoplasmic sperm injection (ICSI) is a more invasive option than conventional in-vitro fertilisation (IVF), which can be successful even when semen characteristics are poor. Reports of higher fertilisation rates after ICSI suggest that this technique may be better than the conventional method for all couples seeking IVF. We undertook multicentre randomised controlled trial comparing clinical outcome after ICSI or traditional IVF in couples with non-male-factor infertility. than IVF. conventional undertook.Methods 415 eligible and consenting couples at four UK centres were randomly assigned IVF or ICSI (total 435 treatment cycles: IVF 224; ICSI 211). Usual clinical and laboratory protocols for the two treatment procedures were followed in each of four participating centres. The primary outcome was the implantation rate (number of gestation sacs per embryo replaced expressed as a percentage). Secondary outcomes were pregnancy and fertilisation rates associated with each treatment. Analyses were by intention to treat.Findings The implantation rate was higher in the IVF group than in the ICSI group (95/318 [30%] vs 72/325 [22%]; relative risk 1.35 [95% CI 1.04-1.76]). The pregnancy rate per cycle was also higher after IVF (72 [33%] vs 53 [26%]; 1.17 [0.97-1.35]). Mean associated laboratory time was significantly shorter with IVF than with ICSI (22.9 [SD 12.1] vs 74.0 [38.1] min; 95% CI for difference 45.6-56.6).Interpretation ICSI offers no advantage over IVF in terms of clinical outcome in cases of non-male-factor infertility. Our results support the current practice of reserving ICSI only for severe male-factor problems.

AB - Background Intracytoplasmic sperm injection (ICSI) is a more invasive option than conventional in-vitro fertilisation (IVF), which can be successful even when semen characteristics are poor. Reports of higher fertilisation rates after ICSI suggest that this technique may be better than the conventional method for all couples seeking IVF. We undertook multicentre randomised controlled trial comparing clinical outcome after ICSI or traditional IVF in couples with non-male-factor infertility. than IVF. conventional undertook.Methods 415 eligible and consenting couples at four UK centres were randomly assigned IVF or ICSI (total 435 treatment cycles: IVF 224; ICSI 211). Usual clinical and laboratory protocols for the two treatment procedures were followed in each of four participating centres. The primary outcome was the implantation rate (number of gestation sacs per embryo replaced expressed as a percentage). Secondary outcomes were pregnancy and fertilisation rates associated with each treatment. Analyses were by intention to treat.Findings The implantation rate was higher in the IVF group than in the ICSI group (95/318 [30%] vs 72/325 [22%]; relative risk 1.35 [95% CI 1.04-1.76]). The pregnancy rate per cycle was also higher after IVF (72 [33%] vs 53 [26%]; 1.17 [0.97-1.35]). Mean associated laboratory time was significantly shorter with IVF than with ICSI (22.9 [SD 12.1] vs 74.0 [38.1] min; 95% CI for difference 45.6-56.6).Interpretation ICSI offers no advantage over IVF in terms of clinical outcome in cases of non-male-factor infertility. Our results support the current practice of reserving ICSI only for severe male-factor problems.

KW - TUBAL FACTOR

KW - FERTILIZATION

KW - SEMEN

KW - IMPLANTATION

KW - PROGRAM

KW - EMBRYOS

KW - COUPLES

KW - ICSI

KW - AGE

U2 - 10.1016/S0140-6736(00)05179-5

DO - 10.1016/S0140-6736(00)05179-5

M3 - Article

VL - 357

SP - 2075

EP - 2079

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 9274

ER -