Randomized allocation of oocytes to IVF or ICSI for IVF-naïve cases with unexplained infertility in an IVF-ICSI Split protocol favors ICSI to optimize live birth outcomes

In assisted reproduction treatments (ART), applying the ICSI method for fertilization of oocytes rather than traditional IVF method, is regarded as controversial two reasons, namely utility and safety. Our study examines an IVF-ICSI Split model couples with unexplained infertility, where male factor meticulously excluded ART conducted by a strict algorithm, commitment to blastocyst culture, along single embryo transfers high cryopreservation. From 242 treatment cycles, 3346 recovered (13.8 per OPU) were randomly allocated or rates standardized number 2PNS arising from each group metaphase II oocyte identified group, denominator both groups. The significantly higher overall (83.2% vs 65.4%; p<0.0001), being most pronounced women under 40 years. resultant embryos had equivalent implantation in fresh ET frozen (FET) cycles no significant differences pregnancy rates, miscarriage live birth outcomes indicating quality. However, there numbers ICSI-generated cryopreserved subsequent FET procedures showed (21 births 6 births; p<0.005) potential livebirths (214 104 p<0.0001). No congenital fetal abnormalities detected any 199 babies delivered during period December 2020, neither IVF-generated nor ICSI-generated. Whilst data strongly favors ICSI, 2 (from 26 one arm only) who demonstrated only study. We conclude that should be undertaken on all IVF-naïve infertility determine appropriate mode, albeit will safely preferred >90% cases.