Zili Lv

Objective To investigate the effects of in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) on the clinical outcomes of non-male factor patients aged >35 with three or fewer oocytes retrieved. Design Retrospective cohort study. Setting Reproductive centre of a university-affiliated hospital in China. Participants 547 women with non-male factor infertility who underwent assisted reproductive technology (ART) treatment with three or fewer oocytes retrieved were identified from June 2019 to May 2022. Of these 547 patients, 334 were treated with IVF and 213 with ICSI. Outcome measures The primary outcomes were normal fertilisation rate, live birth rate per transfer and cumulative live birth rate per retrieval. Results The baseline characteristics were comparable between the two groups, except for the proportion of primary infertility, which was higher in the ICSI group (17.66% vs 32.86%, p=0.000). Compared with the IVF group, the ICSI group showed higher normal fertilisation rate and lower cycle cancellation rate (65.99% vs 76.56%, p=0.002; 33.53% vs 24.41%, p=0.023). However, no significant differences were found in clinical pregnancy rate per transfer (23.86% vs 18.92%, p=0.545), miscarriage rate per fresh embryo transfer (19.05% vs 28.57%, p=0.595), live birth rate per transfer (17.05% vs 13.51%, p=0.623), cumulative clinical pregnancy rate per retrieval (12.87% vs 11.27%, p=0.576) and cumulative live birth rate per retrieval (9.28% vs 6.57%, p=0.261) between the two groups (p>0.05). Conclusions In non-male factor ART cycles, ICSI was not associated with improved pregnancy outcomes in older women with a low number of oocytes retrieved. Routine use of ICSI is not recommended in older women who are infertile due to non-male factors.

OBJECTIVE There are not a few embryos derived from abnormal 2PN zygotes or embryo. For patients with non-normal available embryos, whether such embryos are discarded or continue to be transplanted have always been a concern of clinicians. This paper conducts research and analysis on this issue. STUDY DESIGN: This is a retrospective control study. All data collected was based on two IVF center between July 2011 and July 2021. We analyzed the clinical pregnancy rate and live birth rate derived from four kinds of abnormal 2PN embryos transplanted at the cleavage phases or blastocyst phases over the past 10 years. These data were statistically analyzed compared with the normal 2PN control group. RESULTS Among 50271 zygotes or embryos obtained from oocyte retrieval, 2PN, 0PN, 1PN,MNB and SERa accounted for 58.02%, 13.77%, 4.93%, 0.78% and 0.54%, respectively. After the transplantation of 3250 frozen-thawed cleavage embryos included in the study criteria, the clinical pregnancy rates of 2PN, 0PN, 1PN,MNB and SERa were: 48.6%, 18.6%, 12.4%, 25.5%, 10.7%, and the live birth rates were: 41.9%, 13.1%, 10.0%, 20.8%, 8.0%, respectively. After the transplantation of 3618 frozen-thawed blastocysts included in the study criteria, the clinical pregnancy rates of 2PN, 0PN, 1PN,MNB and SERa were: 59.4%, 48.3%, 47.6%, 51.7%, 53.1%, and the live birth rates were: 50.3%, 38.9%, 40.1%, 43.2%, 42.9%, respectively. Further analysis showed that the live birth rate of0PN, 1PN,MNB and SERacleavage embryo transplantation was only 19.1%-49.6%of normal 2PN cleavage embryo, while the live birth rate of 0PN, 1PN,MNB and SERablastocyst transplantation was 77.3%-85.9% of normal 2PN blastocyst. CONCLUSION When no normal 2PN embryos are available for transplantation, abnormal 2PN embryos are transplanted after being cultured to the blastocyst and the live birth rate close to that of a normal 2PN embryo can be obtained.