Page 66 - PRECONGRESS COURSE 03

FERTILIZATION FAILURES
IVF → ICSI
• What if fertilization failure from IVF? • Is ICSI the next best approach?
• Split IVF-ICSI cycle approach
• Meta-analysis of 11 studies for 902 couples with unexplained infertility (11,767 sibling oocytes) (Johnson et al., 2013)
• ICSI improves fertilization rate
• ICSI is protective against TFF
• Impact on pregnancy outcomes to be determined
• Benefits of split cycles for both diagnosis and treatment • Take-home messages:
• Offer patients with well-defined unexplained fertility the option of using ICSI for some or all of their oocytes
• ICSI cannot overcome all fertilization failures
FERTILIZATION FAILURE
POTENTIAL CULPRITS
• Male gamete
• Female gamete • Both
• Multiplicity of targets
• Complexity of fertilization events
• Diversity of defects from investigational reports to date
• Prevalence of different abnormality types in IVF vs. ICSI
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