Skip to main content

Advertisement

SpringerLink
Log in

Pre-implantation genetic diagnosis—should we use ICSI for all?

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Objective

Intracytoplasmic sperm injection (ICSI) is commonly used during pre-implantation genetic diagnosis (PGD) in vitro fertilization (IVF), aiming to eliminate the risk of contamination from extraneous sperm DNA. Recently, ICSI “overuse” in non-male infertility has been doubted, since it does not offer an advantage over IVF. Prompted by the aforementioned observations, we sought to assess the accuracy of IVF vs ICSI in PGD cases, as might be reflected by a difference in the prevalence of discarded embryos as a consequent of parental contamination.

Methods

Cohort-historical study of all consecutive patients admitted to the IVF-PGD program in a large tertiary center. The percentages of complete, incomplete diagnosis, PCR failure, abnormal embryos, and the contamination rate with paternal DNA in the IVF-only and the ICSI-only groups. We reviewed the computerized files of all consecutive women admitted to our IVF for a PGD-PCR cycle. Patients were divided accordingly into three groups: an IVF group—where all the oocytes underwent IVF only, an ICSI group—where all oocytes underwent ICSI, and a mixed group—where sibling oocytes underwent both IVF and ICSI. The laboratory data and the genetic diagnostic results were collected and compared between the different insemination groups.

Results

Nine-hundred and twenty-seven patients underwent IVF-PGD cycles in our program, 315 in the IVF group, 565 in the ICSI group, and 47 in the mixed group. No differences were observed in fertilization rates, the percentage of embryos available for biopsy, and the percentages of complete, incomplete diagnosis, PCR failure, or abnormal embryos, between the IVF-only and the ICSI-only groups and between the IVF and the ICSI of sibling oocytes in the mixed group. Moreover, contamination with paternal DNA, through contamination with sperm cells, was negligible. Not one single case of misdiagnosis was encountered during the study period.

Conclusion

It might be therefore concluded that IVF should be the preferred insemination methods in PGD cycles, and ICSI should be indicated only in cases of male-factor infertility.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Harton GL, Magli MC, Lundin K, Montag M, Lemmen J, ESHRE PGD, et al. Consortium/embryology special interest group-best practice guidelines for polar body and embryo biopsy for preimplantation genetic diagnosis/screening (PGD/PGS). Hum Reprod. 2011;26:41–6.

    Article  CAS  PubMed  Google Scholar 

  2. Berger VK, Baker VL. Preimplantation diagnosis for single gene disorders. Semin Reprod Med. 2014;32:107–13.

    Article  PubMed  Google Scholar 

  3. De Rycke M, Belva F, Goossens V, Moutou C, SenGupta SB, ESHRE PGD, et al. Consortium data collection XIII: cycles from January to December 2010 with pregnancy follow-up to October 2011. Hum Reprod. 2015;30:1763–89.

    Article  PubMed  Google Scholar 

  4. Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic sperm injection of single spermatozoon into the oocyte. Lancet. 1992;340:17–8.

    Article  CAS  PubMed  Google Scholar 

  5. Evers JLH. Santa Claus in the fertility clinic. Hum Reprod. 2016;31:1381–2.

    Article  PubMed  Google Scholar 

  6. Bhattacharya S, Hamilton MP, Shaaban M, Kalaf Y, Seddler M, Ghobara T, et al. Conventional in-vitro fertilization versus intracytoplasmic sperm injection for the treatment of non-male-factor infertility: a randomised controlled trial. Lancet. 2001;357:2075–9.

    Article  CAS  PubMed  Google Scholar 

  7. Tannus S, Son WY, Gilman A, Younes G, Shavit T, Dahan MH. The role of intracytoplasmic sperm injection in non-male factor infertility in advanced maternal age. Hum Reprod. 2017;32:119–24.

    PubMed  Google Scholar 

  8. ASRM, the practice committees of the American Society for Reproductive Medicine and Society for Assisted Reproductive Technology. Intracytoplasmic sperm injection (ICSI) for non-male factor infertility: a committee opinion. Fertil Steril. 2012;98:1395–9.

    Article  Google Scholar 

  9. Orvieto R, Brengauz M, Feldman BA. Novel approach to normal responder patient with repeated implantation failures—a case report. Gynecol Endocrinol. 2015;31:435–7.

    Article  PubMed  Google Scholar 

  10. World Health Organization. WHO Laboratory manual for the examination and processing of human semen. 5th ed. Geneva: WHO Press; 2010.

    Google Scholar 

  11. Dotan K, Feldman B, Goldman B, Peri Y, Peleg L. The single cell as a tool for genetic testing: credibility, precision, implication. J Assist Reprod Genet. 2010;27(6):335–41.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Infertility and IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel

    Baruch Feldman, Adva Aizer, Masha Brengauz, Jacob Levron, Eyal Schiff & Raoul Orvieto

  2. Danek Gertner Institute of Human Genetics, Sheba Medical Center, Ramat-Gan, Israel

    Baruch Feldman & Keren Dotan

  3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Baruch Feldman, Jacob Levron, Eyal Schiff & Raoul Orvieto

  4. The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Raoul Orvieto

Authors
  1. Baruch Feldman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adva Aizer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masha Brengauz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Keren Dotan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jacob Levron
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eyal Schiff
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Raoul Orvieto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Raoul Orvieto.

Ethics declarations

Competing interests

The authors declare that they have no competing interests.

All authors read and approved the final manuscript.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Feldman, B., Aizer, A., Brengauz, M. et al. Pre-implantation genetic diagnosis—should we use ICSI for all?. J Assist Reprod Genet 34, 1179–1183 (2017). https://doi.org/10.1007/s10815-017-0966-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-017-0966-7

Keywords

Search

Navigation