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Indications affect neonatal outcomes following early rescue ICSI: a retrospective study

  • Assisted Reproduction Technologies
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Abstract

Purpose

To investigate the impact of heterogeneity in patient indications or insemination protocols on neonatal outcomes of singletons following early rescue ICSI (rICSI) treatments.

Methods

A retrospective study was conducted. Propensity score matching and multivariable logistic regression were used to adjust for confounders and biases.

Results

A total of 9095 IVF patients, 2063 ICSI patients, and 642 early rICSI patients were included in the study. No differences were detected in neonatal outcomes except small for gestational age (SGA) which increased in early rICSI patients compared with both unmatched and matched IVF groups with the risk ratio (RR) of 1.31 (95% CI: 1.05, 1.64) and 1.49 (95% CI: 1.05, 2.12). Further analysis showed that SGA increased significantly in partial fertilization failure (PFF) cycles with RRs of 1.56 (95% CI: 1.08, 2.27) and 1.78 (95% CI: 1.22, 2.59) compared with both unmatched and matched IVF patients but not in TFF patients. A positive association between fertilization rate via IVF and birth weight z-score was revealed in the PFF patients.

Conclusion

Early rICSI in patients with total fertilization failure (TFF) appeared to be safe in terms of neonatal outcomes. However, when expanding the indications of rICSI to PFF patients, the SGA in the offspring increased, suggesting a potential effect on long-term health. Since other treatment options, such as using only the IVF-origin embryos still exist for these patients, further studies were needed to confirm the optimal decision for these patients.

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Acknowledgements

We appreciate all clinicians, embryologists, and nurses of the Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital for their treatments provided to the infertile couples included in the study.

Funding

This work was supported by the Natural Science Foundation of Xiamen Municipality, China (grant no. 3502Z202373122); the National Natural Science Foundation of China (grant no. 22176159); and the Xiamen Medical Advantage subspecialty construction project (grant no. 2018296).

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Author notes

  1. Jie Geng and Jiali Cai contributed equally to this work.

Authors and Affiliations

  1. Reproductive Medicine Center, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China

    Jie Geng, Jiali Cai, Lanlan Liu, Zhenfang Liu, Caihui Ma, Xiaoming Jiang & Jianzhi Ren

  2. School of Medicine, Xiamen University, Xiamen, 361005, Fujian, China

    Jiali Cai, Lanlan Liu & Xiaoming Jiang

  3. Medical Quality Management Department, Xiamen University Affiliated Chenggong Hospital, Xiamen, 361003, Fujian, China

    Ling Ouyang

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  1. Jie Geng
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Contributions

JG, XJ, JC, LL, and JR contribute to the conception, design, and manuscript. XJ, LO, CY, KC, XY, ZL, and JC contribute to the acquisition of data. JG, XJ, CM, and JC contribute to the analysis and interpretation of data. All authors read and approved the manuscript; all data were generated in-house, and no paper mill was used.

Corresponding author

Correspondence to Xiaoming Jiang.

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Ethical approval

The study was approved by the Institutional Review Board from the Ethical Committee of the Medical College Xiamen University.

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Informed consent was unnecessary because the research was based on non-identifiable records approved by the ethics committee.

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Informed consent was unnecessary because the research was based on non-identifiable records approved by the ethics committee.

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The authors declare no competing interests.

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Geng, J., Cai, J., Ouyang, L. et al. Indications affect neonatal outcomes following early rescue ICSI: a retrospective study. J Assist Reprod Genet 41, 661–672 (2024). https://doi.org/10.1007/s10815-024-03040-w

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  • DOI: https://doi.org/10.1007/s10815-024-03040-w

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