Department of Obstetrics and Gynaecology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Department of Obstetrics and Gynaecology, Faculty of Medicine, Assiut University, Assiut, Egypt; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA.
J Gynecol Obstet Hum Reprod. 2020 Jun;49(6):101706. doi: 10.1016/j.jogoh.2020.101706. Epub 2020 Feb 1.
To evaluate the evidence about in-vitro fertilization (IVF) versus intracytoplasmic sperm injection (ICSI) for the treatment of non-male factor infertility.
Electronic databases searched using the following MeSH terms (Sperm Injection, Intracytoplasmic) AND (in Vitro Fertilisation) AND (Infertility).
All RCTs included infertile patients due to non-male factors underwent IVF or ICSI were considered for this meta-analysis. One-thousand twenty-two studies were identified of which 20 studies deemed eligible for this review.
Three independent authors extracted the relevant data from included studies. The study outcomes were pooled in the form of relative risk (RR) and 95 % confidence interval (CI) using Mantel-Hansel method. The main outcome measures are the fertilization rate, the implantation rate, the clinical pregnancy rate (CPR), the total fertilization failure and the live birth rate.
Regarding the fertilization rate, the pooled estimate did not favour either IVF or ICSI group (RR = 0.94; 95 %CI [0.82, 1.07]; p = 0.34). However, IVF significantly increased the CPR than ICSI (RR = 1.28, 95 %CI [1.11, 1.49]; p = 0.001). The overall effect estimate did not favor either of two groups regarding the implantation rate (RR = 1.25, 95 % CI [0.92, 1.68], p = 0.15). Similarly, no difference between both groups regarding the live birth rate (RR = 1.08, 95 % CI [0.79, 1.49]; p = 0.62).
No difference between ICSI and IVF regarding fertilization rate per oocytes, implantation rate and live birth rate in the treatment of non-male factor infertility, while IVF has significantly higher clinical pregnancy rate and higher risk of total fertilization failure.
评估体外受精（IVF）与胞浆内单精子注射（ICSI）治疗非男性因素不孕的证据。
使用以下 MeSH 术语（精子注射，胞浆内）和（体外受精）和（不孕）搜索电子数据库。
所有因非男性因素而接受 IVF 或 ICSI 的不孕患者均进行了这项荟萃分析。共确定了 1022 项研究，其中 20 项研究被认为符合本综述的条件。
三名独立作者从纳入的研究中提取了相关数据。使用 Mantel-Hansel 方法，以相对风险（RR）和 95%置信区间（CI）的形式汇总研究结果。主要结局指标是受精率、着床率、临床妊娠率（CPR）、总受精失败率和活产率。
关于受精率，合并估计不支持 IVF 或 ICSI 组（RR=0.94；95%CI[0.82,1.07]；p=0.34）。然而，IVF 显著提高了 CPR 而不是 ICSI（RR=1.28，95%CI[1.11,1.49]；p=0.001）。关于着床率，两组之间的总体效应估计没有任何差异（RR=1.25，95%CI[0.92,1.68]，p=0.15）。同样，两组之间的活产率没有差异（RR=1.08，95%CI[0.79,1.49]；p=0.62）。
在治疗非男性因素不孕方面，ICSI 和 IVF 在每卵受精率、着床率和活产率方面没有差异，而 IVF 具有显著更高的临床妊娠率和更高的总受精失败风险。
