Impact of a modified ICSI injection procedure in ART outcomes: preliminary findings

The objective of this study was to evaluate if several pushes in oolema membrane at the moment of injection together with the deposition of spermatozoa under the oocyte's cortex impact ICSI outcomes. Matched case-control study. A total of 178 patients who were submitted to ICSI procedure were include. At the moment of ICSI procedure, two differs injection procedures was performed:-Group 1/standard ICSI(n:114)-patient who in all their MII oocytes ICSI was performed with standard injection procedure. Standard injection procedure included those oocytes, in which at the moment of the injection, the injecting needle was pushed once against the oocytes and introduced till the center of the oocyte, where the spermatozoa was deposited.-Group 2/modified ICSI(n:64)-patients who in all their MII oocytes ICSI was performed with a modified injection procedure. Modified injection procedure included those oocytes at the moment of the injection, the injecting needle was pushed at least 3 times against the oocytes and introduced till the cortex of the oocyte, where the spermatozoa was deposited. The following parameters were evaluated in each group: patient age, number of oocytes in metaphase II retrieved, fertilization rate, number of embryos transferred, implantation rate and pregnancy rate. Patients who had their oocytes injected by a modified injection procedure showed an adequate fertilization (64.9%), and higher implantation rate (25%), pregnancy rate/cycle (42%) and pregnancy rate/transfer(46%) compared with those patients in which a standard ICSI injection procedure was performed (fertilization rate:62.2%, implantation:14.7%, pregnancy rate/cycle:23%, pregnancy rate/transfer:26%). A decrease in fertilization failures was also observed in the group 2 (modified ICSI), however not significant. Table 1 shows the results.Table 1ResultsStandard ICSIModified ICSIPn11464Age(years)37.8±3.837.8±4.20.4MII oocytes(n)5.2±3.25.8±3.70.5Fertilization(%)62.2±27.164.9±32.00.2Fertilization failure(%)13.2%7.8%0.3Embryos transferred(n)2.0±0.82.2±0.70.2Implantation rate(%)14.7%25%0.01Clinical pregnancy rate/cycle(%)23%42%0.01Clinical pregnancy rate/transfer(%)26%46%0.01 Open table in a new tab The modified injection ICSI procedure seems to be useful for improve implantation and clinical pregnancy rates, with satisfactory results. Additional date will be important to provide more information.