INTRACYTOPLASMIC SPERM INJECTION (ICSI) DOES NOT PROVIDE ANY BENEFIT OVER IN VITRO FERTILIZATION (IVF) ON PLOIDY RATES IN NON-MALE FACTOR INFERTILITY CYCLES UNDERGOING PRE-IMPLANTATION GENETIC TESTING FOR ANEUPLOIDY (PGT-A)

Early PGT-A platforms required use of ICSI to eliminate paternal DNA contamination. Advances in genetic testing platforms, such as Next Generation Sequencing (NGS), allow for the use of IVF or ICSI. Despite clinical indication, ICSI is currently the recommended fertilization method for PGT-A cycles 1. Our objective is to evaluate whether significant differences exist in ploidy rates from PGT-A tested embryos fertilized by IVF compared to ICSI. Retrospective cohort study at a single academic institution. All embryos from ICSI and IVF cycles performed from 1/2016 to 2/2020 that underwent NGS PGT-A from trophectoderm biopsy were evaluated. Exclusion criteria included male factor infertility, embryos tested for PGT for monogenic disorders, structural rearrangements, or HLA-typing, cryopreserved oocytes, blastomere or polar body biopsy, in vitro maturation, rescue ICSI, or split IVF/ICSI cycles. Patient demographics, infertility diagnoses, cycle characteristics, and embryo PGT-A results for euploid, aneuploid, low and high mosaicism, and no call rates were collected. Primary outcome was euploid embryo rates. Secondary outcomes were aneuploid and mosaic rates. Chi-square or Fisher’s exact test and Mann-Whiney test were used for categorical and continuous variables, respectively. Outcomes of IVF vs. ICSI groups were compared using generalized linear mixed models, in which euploid and aneuploid rates were adjusted for confounding variables attained during the univariate screen. Continuous variables are reported as median with interquartile range. Outcomes variables are reported as mean (95% CI). Results were considered statistically significant with a p-value <0.05. Analyses were performed using SAS version 9.4 A total of 1517 embryos from 387 cycles met criteria, 789 embryos from IVF (52.0%) and 728 embryos from ICSI (47.9%) cycles. Median age in IVF vs. ICSI group were 38 (35 ,40) and 38.5 (36 ,41) years, respectively. Median AMH in IVF vs. ICSI group was 1.8 ng/ml (1 ,3.7), and 2.1 (1.18 ,2.9) ng/ml, respectively. Average embryos biopsied in IVF vs. ICSI group were 4 (2 ,6) vs. 3 (1 ,5), respectively. Euploid, aneuploid, mosaic, and no call rates demonstrated no significant differences in IVF vs. ICSI inseminated groups (Table 1). The use of ICSI in non-male factor infertility cycles undergoing PGT-A does not provide an advantage over IVF for euploid or mosaic rates.Table 1IVFICSIp-valueEuploid0.43 (0.34, 0.51)0.42 (0.34, 0.49)0.76Aneuploid0.40 (0.31, 0.49)0.43 (0.37, 0.52)0.37No call0.02 (0.005, 0.03)0.03 (0.01, 0.04)0.35Mosaic0.15 (0.11, 0.19)0.13 (0.09, 0.17)0.39Low Mosaic0.07 (0.04, 0.09)0.06 (0.04, 0.09)0.79High Mosaic0.08 (0.053, 0.11)0.07 (0.04, 0.09)0.41 Open table in a new tab