Department of Obstetrics and Gynecology, McGill University, 1001 Decarie Boulevard, Montreal, QC, H4A 3J1, Canada.
The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Assist Reprod Genet. 2022 May;39(5):1135-1141. doi: 10.1007/s10815-022-02404-4. Epub 2022 Mar 21.
To assess obstetric outcomes and placental histology following intracytoplasmic sperm injection (ICSI), for non-male infertility.
This was a retrospective cohort of live born singleton deliveries after in vitro fertilization (IVF) at a single university affiliated medical center between 2009 and 2017. Excluded were IVF cycles with male infertility and oocyte recipients. We compared obstetric outcomes and placental histology in cases ICSI was performed (ICSI group) and cases with no ICSI (IVF group).
A total of 400 deliveries following ICSI were compared to 218 in the IVF group. Maternal age was similar between the groups, while diminished ovarian reserve was more common among ICSI patients and tubal disease less common (p < 0.001). The rate of blastocyte transfer was also significantly lower in the ICSI group-67.5% vs. 77%, p = 0.01. Pregnancies following ICSI were characterized by similar rates of preeclampsia, preterm birth, and small for gestational age neonates. Although cesarean delivery rate was significantly higher in the group, this did no attain significance after adjustment for confounders. Placentas in the ICSI group were notable for a lower rate of villitis of unknown etiology (1% vs. 4.5%, p = 0.007) and a higher rate of maternal surface calcifications (33% vs. 23.8%, p = 0.01) after adjustment for confounders.
The employment of ICSI with no male indication is associated with similar obstetric outcomes. Despite isolated placental differences among many investigated, placental histology seems overall comparable as well. These results are reassuring to clinicians and patients.
评估非男性因素不育患者行卵胞浆内单精子注射（ICSI）后生育的产科结局和胎盘组织学表现。
这是一项回顾性队列研究，纳入了 2009 年至 2017 年期间在一家大学附属医院进行的体外受精（IVF）后活产单胎分娩。排除男性因素不育和卵母细胞受体的 IVF 周期。我们比较了行 ICSI（ICSI 组）和未行 ICSI（IVF 组）的病例的产科结局和胎盘组织学表现。
共比较了 400 例 ICSI 分娩和 218 例 IVF 分娩。两组的产妇年龄相似，但 ICSI 患者的卵巢储备功能减退更为常见，而输卵管疾病较少见（p<0.001）。ICSI 组的胚胎移植率也显著降低-67.5%比 77%，p=0.01。ICSI 后妊娠的子痫前期、早产和小于胎龄儿的发生率相似。虽然 ICSI 组的剖宫产率显著升高，但在调整混杂因素后无统计学意义。ICSI 组胎盘的不明病因绒毛膜炎发生率较低（1%比 4.5%，p=0.007），经混杂因素调整后母体表面钙化的发生率较高（33%比 23.8%，p=0.01）。
在没有男性指征的情况下使用 ICSI 与相似的产科结局相关。尽管许多研究中存在孤立的胎盘差异，但胎盘组织学似乎总体上也相似。这些结果令临床医生和患者感到放心。
