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No advantage of laser-assisted over conventional intracytoplasmic sperm injection: a randomized controlled trial [NCT00114725]

Journal of Experimental & Clinical Assisted Reproduction volume 3, Article number: 5 (2006) Cite this article

Abstract

Background

Intracytoplasmic sperm injection (ICSI) is a component of infertility treatment often employed when conventional in vitro fertilization is unlikely to be successful. Despite good clinical results with ICSI, the procedure is typically associated with degeneration of a significant percentage (approximately 10%) of the treated oocytes. The cause of this degeneration remains unclear. Speculation that damage caused by oocyte compression during the injection procedure may be responsible has led to the development of a novel technique known as laser-assisted ICSI. This procedure involves drilling a small hole through the zona pellucida with a laser prior to sperm injection. Preliminary studies have suggested that laser-assisted ICSI may dramatically reduce oocyte degeneration rates. The objective of this study was to examine whether the reported benefits of laser-assisted ICSI could be verified on a larger, less-selected group of patients.

Methods

Oocytes retrieved from 59 patients scheduled for ICSI were randomly divided into equal treatment and control groups. Oocytes in the treatment group were inseminated by laser-assisted ICSI, while oocytes in the control group were inseminated by conventional ICSI. Outcome variables (oocyte fertilization and degeneration, embryo cell numbers and fragmentation on days 2 and 3, and compaction and blastocyst formation rates) were compared between treatment and control groups by paired-sample t-test. Subgroup analysis was performed according to zona pellucida and oolemma breakage patterns.

Results

No significant differences between treatment and control groups were observed for any of the measured outcome variables. However, fragile zonae pellucidae were associated with significantly poorer embryo quality, and fragile oolemmas that broke easily upon insertion of the injection needle were associated with a significantly higher oocyte degeneration rate. Nevertheless, there were also no between-treatment differences in clinical outcomes within these patient subpopulations.

Conclusion

Contrary to previous reports based on smaller sample sizes, the results of this study suggest that there is no benefit of laser-assisted ICSI, either for the general population of ICSI patients, or for patients prone to zona pellucida or oolemma fragility.

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Acknowledgements

We thank James Graham and Taer Han for assistance in performing ICSI treatments.

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Authors and Affiliations

  1. Shady Grove Fertility Reproductive Science Center, Rockville, MD, 20850, USA

    Kevin S Richter, Alana Davis, Jennifer Carter, Stephen J Greenhouse, Gilbert L Mottla & Michael J Tucker

Authors
  1. Kevin S Richter
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  2. Alana Davis
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  3. Jennifer Carter
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  4. Stephen J Greenhouse
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  5. Gilbert L Mottla
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  6. Michael J Tucker
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Corresponding author

Correspondence to Kevin S Richter.

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Competing interests

The author(s) declare that they have no competing interests.

Authors' contributions

AD and MT conceived the study. AD, MT, KR, and SG designed the study protocol. AD and JC performed ICSI treatments and collected data. KR performed the statistical analysis. KR, SG and GM drafted the manuscript. All authors read and approved the final manuscript.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Richter, K.S., Davis, A., Carter, J. et al. No advantage of laser-assisted over conventional intracytoplasmic sperm injection: a randomized controlled trial [NCT00114725] . J Exp Clin Assist Reprod 3, 5 (2006). https://doi.org/10.1186/1743-1050-3-5

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  • DOI: https://doi.org/10.1186/1743-1050-3-5

Journal of Experimental & Clinical Assisted Reproduction

ISSN: 1743-1050