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Hum. Reprod. Advance Access originally published online on February 10, 2005
Human Reproduction 2005 20(5):1261-1265; doi:10.1093/humrep/deh786
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions{at}oupjournals.org

IVF versus ICSI in sibling oocytes from patients with polycystic ovarian syndrome: a randomized controlled trial

Jiann-Loung Hwang1,2,5, Kok-Min Seow1,4, Yu-Hung Lin1,3, Bih-Chwen Hsieh1,3, Lee-Wen Huang1, Heng-Ju Chen1, Shih-Chia Huang1, Chin-Yu Chen1, Pei-Hsin Chen1 and Chii-Ruey Tzeng2

1 Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 2 Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, 3 College of Medicine, Fu Jen Catholic University, Sinchuang City, Taipei County and 4 Department of Obstetrics and Gynecology, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan

5 To whom correspondence should be addressed at: Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen Chang Road, Shih Lin District, Taipei 111, Taiwan. Email: m001015{at}ms.skh.org.tw

BACKGROUND: This study compares the fertilization rate and embryonic development of oocytes randomly inseminated by conventional IVF or ICSI in patients with polycystic ovarian syndrome (PCOS) and normozoospermic semen during IVF cycles. METHODS: Sibling oocytes were randomized to be inseminated either by ICSI or IVF. Fertilization rate (two pronuclei/COC), day 2 embryonic morphology and rate of development were assessed. RESULTS: A total of 1089 cumulus–oocyte complexes (COC) were collected in 60 cycles (mean±SD, 18.2±7.2). Totals of 541 and 548 COC were inseminated by IVF and ICSI respectively, with a significantly higher fertilization rate in the ICSI group (ICSI versus IVF, 72.3±15.5 versus 44.8±25.1%). No fertilization failure occurred in the group of oocytes inseminated by ICSI, whereas the COC in nine patients (15%) inseminated by IVF had complete fertilization failure. The day 2 embryonic morphology and rate of development were not different regardless of the insemination method. CONCLUSIONS: Our results suggested that another randomized controlled study, randomizing patients instead of sibling oocytes, should be undertaken to compare the pregnancy rate per started cycle and to see whether ICSI should be performed on all, or at least on a portion of, oocytes for patients with PCOS undergoing IVF cycles.

Key words: ICSI/IVF/PCOS/sibling oocytes


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