Archives of Gynecology and Obstetrics

, Volume 297, Issue 5, pp 1301–1306 | Cite as

Conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI): which is preferred for advanced age patients with five or fewer oocytes retrieved?

  • Hui Liu
  • Haibin Zhao
  • Guanling Yu
  • Mei Li
  • Shuiying Ma
  • Haozhen Zhang
  • Keliang Wu
Gynecologic Endocrinology and Reproductive Medicine



To investigate the clinical outcomes of conventional IVF and ICSI in female patients aged 40 years and over with no more than five oocytes retrieved and non-male factor infertility.


A retrospective study of a cohort of 644 patients undergoing IVF/ICSI treatment. The 534 female patients aged ≧ 40 years with no more than five oocytes retrieved and non-male factor infertility undergoing their first conventional IVF cycles were assigned in IVF group. The rest of 110 patients aged 40 years and over with no more than five oocytes retrieved and non-male factor infertility undergoing first ICSI cycles were recruited in ICSI group.


Our results showed the clinical pregnancy, live birth and miscarriage rates were similar between the IVF and ICSI groups (21.59% vs. 13.25%, P > 0.05; 12.16% vs. 6.02%, P > 0.05; 43.68% vs. 54.55%, P > 0.05; respectively), however, the implantation and cumulative live-birth rates were significantly higher in the IVF compared to the ICSI group (15.11% vs. 7.75%, 14.59% vs. 5.56%, P < 0.05), though the IVF group had a lower normal fertilization rate (61.56% vs. 76.00%, P < 0.001).


Our study provides strong evidences that the conventional IVF exhibits advantages over the ICSI method in non-male factor infertility for advanced age patients with five or fewer oocytes retrieved.


Advanced-age female In vitro fertilization Intracytoplasmic sperm injection Non-male factor infertility Cumulative live birth rate 


Author contributions

LH: data management/analysis, manuscript writing/editing, ZHB: data management/analysis, manuscript writing/editing, YGL: data collection, LM: manuscript editing, MSY: manuscript editing, ZHZ: data collection, WKL: study design, manuscript writing/editing.


This study was funded by Merck Serono China Research Fund for Fertility, National Research on Development Plan (2016YFC1000604) and National Natural Science Foundation of China (No. 81601256 and No. 81401266).

Compliance with ethical standards

Conflict of interest

All the authors declare no conflict of interest with respect to the authorship and/or publication of this article.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the Reproductive Medicine, Shandong University Research Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in this study.

Supplementary material

404_2018_4696_MOESM1_ESM.doc (58 kb)
Supplementary material 1 (DOC 58 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Center for Reproductive MedicineShandong Provincial Hospital Affiliated to Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive GeneticsJinanPeople’s Republic of China
  2. 2.The Key laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Shandong Provincial Key Laboratory of Reproductive MedicineJinanPeople’s Republic of China

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