JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):58
Poster Presentation
29th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263597
P-46. Comparison of Intracitoplasmatic Spermatozoa Injection (ICSI) With Conventional In Vitro Fertilization (IVF) In the Absence of Infertility Male Factor
Andrea Prestes Nácul1, Gabriela Krolow Machado da Silva1, Luana Colares dos Santos da Costa2, Luciane Pansardi Cabrera Baptista1, Talita Giacomet de Carvalho1
1 Hospital Fêmina/ Grupo Hospitalar Conceição - Porto Alegre - RS - Brasil
2 Pontifícia Universidade Católica de Porto Alegre - Porto Alegre – RS - Brasil
Objective: Although ICSI has been associated with more than 5 million live births since its implementation in 1992, concerns are emerging about its universal indication, with experts disagreeing on whether the technique should be performed routinely or only in selected cases of severe male infertility. The aim of this study is to compare clinical and laboratory outcomes of patients undergoing conventional in vitro fertilization (IVF) versus ICSI in the absence of male factor infertility, within an assisted reproduction program offered through the Brazilian Unified Health System (SUS).
Methods: This is a retrospective cohort observational study. A total of 89 couples who underwent conventional IVF between January 2023 and March 2024 (a period during which only conventional IVF was available due to technical issues) and 84 couples who underwent ICSI between January 2020 and December 2023 were included. Patients selected for conventional IVF had semen analysis results with a sperm concentration ≥33 million/mL and total motility ≥80%. Couples with male factor infertility, among other causes, were excluded from the study. The study was approved by our hospital ethic committee.
Results: The mean number of oocytes retrieved was 6.1±4.4 in the conventional IVF group and 6.3±3.7 in the ICSI group, with
no statistically significant difference. The mean number of embryos transferred per patient was 1.8±0.6 in the conventional IVF group and 2.2±0.5 in the ICSI group (p<0.001), with most transfers occurring on day 3 of embryonic development. Regarding pregnancy outcomes, there were no significant differences in pregnancy rate. A trend toward a higher number of live births was observed in the ICSI group, although this did not reach statistical significance (p=0.075). Analysis of perinatal outcomes revealed a significantly lower gestational age at delivery in the conventional IVF group compared to the ICSI group (34.7±3.2 weeks vs. 38.4±1.8 weeks, respectively) (p=0.002). Although prematurity was more frequently observed in the conventional IVF group, there were no significant differences in birth weight, suggesting that prematurity did not markedly impact perinatal outcomes in this population. Regarding gestational complications, a significantly higher rate of preterm premature rupture of membranes (PPROM) was observed in the conventional IVF group (44.4% vs. 0% in the ICSI group, p=0.012), a finding consistent with the lower gestational age at birth in this group. Additionally, gestational diabetes mellitus (GDM) was more prevalent in the conventional IVF group (55.6%) compared to the ICSI group (0%) (p=0.003).
Conclusion: The findings of this study suggest that conventional IVF remains a viable alternative to ICSI in the absence of male factor infertility, in line with current international guidelines. However, further research involving larger sample sizes and longitudinal analyses, including prenatal data, is essential to better elucidate the specific effects of each technique on these outcomes.