The effect of ICSI-related procedural timings and operators on the outcome

Authors

  • John L Yovich Medical Director PIVET Medical Centre Perth, Western Australia, Australia 6007.

DOI:

https://doi.org/10.30574/gscbps.2020.11.1.0075

Keywords:

ICSI timings, Oocyte denudation, Egg stripping, Ovulation induction, Blastocyst development rate, Cumulative livebirth rate

Abstract

A recent publication from a private IVF facility in Rome reports surprising findings in respect to ICSI-related procedural timings. The GENERA group reported on ICSI outcomes with fresh autologous oocytes where the insemination process was conducted with fresh non-donor ejaculated sperm. With primary outcome being the cumulative delivery rate (CDR) and secondary outcome the mean blastulation rate, the group showed that the latter was significantly higher when oocyte denudation for ICSI was performed less than 38 hours from ovulation induction rather than their usual 38-42 hours. Furthermore, they concluded that CDR was not influenced by ICSI timings where oocyte denudation was conducted between 2 to 7 hours from oocyte retrieval. This report has very significant implications for the logistical management of embryology laboratories, but most IVF clinics will be skeptical for two reasons – firstly the GENERA researchers failed to cite any of the early pioneer work regarding IVF insemination times, conducted from various locations in the 1980’s; all showing optimal outcomes when insemination was performed 5.5 to 7.5 hours post oocyte retrieval, matching around 42 hours post ovulation trigger. Secondly, the statistical analysis for their data was rather complex including multivariate logistic regression analyses which did not provide clearly conclusive results, certainly not sufficient to cause long-standing IVF operators to change practice. Within this era of evidence-based medicine, it is difficult to gain confidence in studies that appear to suggest nothing from the first 20 years of IVF was reliable.

Metrics

Metrics Loading ...

References

Maggiulli R, Cimadomo D, Fabozzi G, Papini L, Dovere L, Ubaldi FM and Rienzi L. (2020). The effect of ICSI-related procedural timings and operators on the outcome. Hum Reprod, 1, 1-12.

Yovich JL, Conceicao JL, Marjanovich N, Ye Y, Hinchliffe PM, Dhaliwal SS and Keane KN. (2018). An ICSI rate of 90% minimizes complete failed fertilization and provides satisfactory implantation rates without elevating fetal abnormalities. Reprod Biol, 18, 301-311.

Yovich JL and Craft IL. (2018). Founding pioneers of IVF: Independent innovative researchers generating livebirths within 4 years of the first birth. Reprod Biol, 18, 317-323.

Yovich JL. (2020). Founding pioneers of IVF Update: Independent innovative researchers generating livebirths within 4 years of the first birth. Reprod Biol, 20, 111-113.

Trounson AO, Mohr LR, Wood C and Leeton JF. (1982). Effect of delayed insemination on in-vitro fertilization, culture and transfer of human embryos. J Reprod Fertil, 64(2), 285-294.

Maćas E, Suchanek E, Grizelj V, Simunić V, Puharić I and Drobnjak P. (1983). The effect of delayed insemination on fertilization in vitro and the development of human embryos. Jugosl Gynekol Opstet, 23(5-6), 106-111.

Harrison KL, Pope AK, Wilson LM, Cummins JM, Breen TM and Hennessey JF. (1988). Fertilization of human oocytes in relation to varying delay before insemination. Fertil Steril, 50(2), 294-297.

Yovich JL. (2019). Monitoring the stimulated IVF cycle. In: How to Prepare the Egg and Embryo to Maximise IVF Success. Section II: Stimulation for IVF (Eds: Gabor T Kovacs, Anthony J Rutherford, David K Gardner). Cambridge University Press, Cambridge, 94-120.

Field A. (2013). Discovering statistics using IBM SPSS Statistics. 4th edition. Sage publications, London, 916.

Downloads

Published

2020-04-30

How to Cite

Yovich, . J. L. (2020). The effect of ICSI-related procedural timings and operators on the outcome. GSC Biological and Pharmaceutical Sciences, 11(1), 09–011. https://doi.org/10.30574/gscbps.2020.11.1.0075

Issue

Section

Short Comunication