Document Detail

Conventional in-vitro fertilisation versus intracytoplasmic sperm injection for the treatment of non-male-factor infertility: a randomised controlled trial.
MedLine Citation:
PMID:  11445099     Owner:  NLM     Status:  MEDLINE    
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 a multicentre randomised controlled trial comparing clinical outcome after ICSI or traditional IVF in couples with non-male-factor infertility. 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.
S Bhattacharya; M P Hamilton; M Shaaban; Y Khalaf; M Seddler; T Ghobara; P Braude; R Kennedy; A Rutherford; G Hartshorne; A Templeton
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  357     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-07-10     Completed Date:  2001-07-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  2075-9     Citation Subset:  AIM; IM    
Assisted Reproduction Unit, Aberdeen University, Aberdeen Maternity Hospital, Foresterhill, AB25 2ZD, Aberdeen, UK.
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MeSH Terms
Fertilization in Vitro
Infertility, Male / therapy*
Pregnancy Outcome
Pregnancy Rate
Sperm Injections, Intracytoplasmic*
Comment In:
Lancet. 2001 Nov 10;358(9293):1645-6   [PMID:  11716920 ]
Lancet. 2001 Jun 30;357(9274):2068-9   [PMID:  11445092 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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