The use of the ICSI technique in IVF is increased recently and is being applied in many cases of infertility. In Europe ICSI is used in 65% of IVF cycles and in America in 76%. Generally, ICSI is used in male factor infertilities so can increase the fertilization rate and the number of embryos. But a question that can be generated from this is if ICSI used in non-male factor infertility cases can improve the outcomes compared with conventional IVF in women aged 40 years and over.

A clinic in Montreal, Canada, made a retrospective study included 745 women, aged 40-43 years with non-male factor infertility. 490 of these underwent ICSI and 255 women underwent conventional IVF. So, all of the partners of these women had normal sperm parameters according to World Health Organisation (WHO) fifth edition. The ICSI group had a higher number of previous IVF cycles which could mean that ICSI was used in couples with poorer prognosis. However, after logistic regression analysis the live birth rates were similar between the two groups.

Moreover, even if this study is enough to answer the question of whether ICSI is of value in older women, it’s still not strong to detect differences in live birth rates. So, prospective studies are needed to confirm these findings.

In conclusion, ICSI does not do better than IVF in older women when their partner’s sperm is normal. So, this is another confirmation that ICSI should not be used in cases except of male infertility.

Source: Tannus S et al, Hum Reprod (2017) 32 (1): 119-124

Karagianni Tania, Bsc

Clinical Embryologist

Embryogenesis