ICSI Success Rate by Age
Over the past few decades, the use of ICSI has increased dramatically in fertility clinics. Although it was originally intended for male-factor infertility, it is now used widely even when semen characteristics are normal. Is there a benefit in using ICSI rather than conventional IVF?
In this article, we will zoom in on the success rates of ICSI in different age groups and how the rates compare to conventional IVF.
ICSI Success Rate by Ages
According to the 2015 National Summary Report released by CDC, live birth rates with ICSI treatment decrease as maternal age increases, regardless of the presence of male factor infertility. This trend is expected with all fertility treatments, due to significantly declined egg quality with advancing maternal age.
| Age | <35 | 35-37 | 38-40 | 41-42 | 43-44 | >44 |
| With male factor | 37% | 31% | 22% | 11% | 4% | 1% |
| No male factor | 34% | 28% | 19% | 10% | 4% | 1% |
Success rates of ICSI vs Conventional IVF
Since each couple is unique in the cause of infertility, the answer as to whether ICSI or conventional IVF is more beneficial could vary. A retrospective cohort study published in 2015 is the most comprehensive study so far comparing the two strategies with different infertility factors, which will be the focus here1. A few other smaller-scale studies will also be discussed.
Note that all of the studies discussed here are retrospective studies. They either excluded frozen and donor eggs, or contained predominantly fresh, non-donor eggs.
Currently, a randomized clinical trial is underway and due for completion by December 2020. The outcome of such randomized trial is expected to offer more definitive answers as to whether ICSI is more or less beneficial compared to IVF for non-male factor infertility.
Male Factor Infertility
Among couples with male factor infertility, including abnormal sperm count, motility and morphology, ICSI showed an overall similar success outcome compared to conventional IVF.
The percentage of cycles canceled between egg retrieval and embryo transfer is an indication of failed fertilization. This figure is halved with ICSI as compared to conventional IVF, indicating that it can indeed improve fertilization when the sperm is at fault. However, there are no differences in pregnancy, miscarriage or live birth rates between conventional IVF and ICSI, indicating overall similar success rates.
Non-Male Factor Infertility
Among couples with non-male factor infertility, the use of ICSI is not supported by evidence. The implantation rate, pregnancy rate and live births are lower with ICSI compared to conventional IVF. The miscarriage rate is also slightly higher with ICSI1.
Among live births, the risks for multiple live birth, preterm delivery and low birth weights are similar between IVF and ICSI.
In the 2015 National Summary Report released by CDC, conventional IVF had higher success rates compared to ICSI in non-male infertility cases before the age of 43. After 43, both treatments have very low success rates due to significantly declined egg quality.
Success rates with conventional IVF vs ICSI, adjusted by age (no male factor)
| Age | <35 | 35-37 | 38-40 | 41-42 | 43-44 | >44 |
| Conventional IVF | 38% | 30% | 21% | 11% | 4% | 1% |
| ICSI | 34% | 28% | 19% | 10% | 4% | 1% |
About Iranian Surgery
Iranian surgery is an online medical tourism platform where you can find the best doctors and fertility specialists in Iran. The price of IVF in Iran can vary according to each individual’s case and will be determined by an in-person assessment with the doctor.
For more information about the cost of IVF in Iran and to schedule an appointment in advance, you can contact Iranian Surgery consultants via WhatsApp number 0098 901 929 0946. This service is completely free.
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What Factors Affect the Success Rate of ICSI in Women Under 35?
Several factors can affect the success rate of women under 35, including: . The quality of the sperm used for ICSI . The quality of the embryos produced during the cycle . The number of eggs retrieved during the cycle . The general health of the woman
What Strategies Can be Applied to Improve the Success Rate of ICSI in Women Under 35?
Several strategies can be adopted to improve the success rate of ICSI for women under 35. . These include optimizing lifestyle factors such as maintaining a healthy weight, reducing alcohol and caffeine consumption, and quitting smoking. . Taking prenatal vitamins and supplements such as CoQ10 and folic acid, following a healthy balanced diet with plenty of vegetables, fruits, and whole grains, and engaging in regular exercise (but avoiding vigorous activities that may affect fertility) are also helpful strategies. In addition, women under 35 may consider pre-implantation genetic testing (PGT) to identify embryo chromosomal abnormalities before transfer. This can help increase the chances of a successful pregnancy.
What Factors Affect the Success Rate of ICSI in Women Aged Between 38 and 40?
Several factors can affect the success rate of ICSI for women between the ages of 38 and 40, including: . Age: As a woman ages, the quality and quantity of her eggs decrease, making it more challenging to achieve a successful pregnancy. . Underlying Medical Conditions: Certain medical conditions, such as PCOS, endometriosis, and uterine fibroids, can affect the success of ICSI. . Ovarian Reserve: The number and quality of a woman’s remaining eggs can affect the chances of ICSI success. Women with lower ovarian reserve may have a lower success rate. . Male Partner Factors: Male infertility factors such as poor sperm motility or low sperm count can also affect the success rate of ICSI.
What Strategies Can Be Applied to Improve the Success Rate of ICSI In Women Aged 38 to 40?
There are several strategies that women between the ages of 38 and 40 can consider to improve ICSI success rates, including: . Egg Freezing: Freezing eggs at a younger age and of higher quality can be an option for women who intend to do ICSI. . Pre-Implantation Genetic Testing (PGT): PGT can identify embryos with genetic abnormalities and increase the chances of a successful pregnancy. . Donor Eggs: Sometimes, egg donation may be an appropriate strategy for women with poor egg quality or low ovarian reserve. . Lifestyle Changes: Adopting a healthy lifestyle by reducing alcohol consumption, quitting smoking, and maintaining a healthy weight can increase the chances of success with ICSI. It is important for women to be aware of these factors and talk to their doctor or fertility specialist about intracytoplasmic sperm injection and their specific situation to learn more about success rates.
What Factors Affect the Success Rate of ICSI in Women Over 40?
The success rate of ICSI in women over 40 can be influenced by various factors. The main factor is age, because the quality and quantity of eggs decreases with age. Other factors include underlying medical conditions, male factor, lower ovarian reserve, lifestyle factors such as smoking, alcohol consumption, and being overweight, the number of previous IVF/ICSI treatments, and the quality of the laboratory where the procedure is performed. Women should consult with a fertility specialist to determine the best course of action based on their circumstances.
What Strategies Can Be Applied to Improve the Success Rate of ICSI in Women Over 40?
Apart from PGT (Pre-Implantation Genetic Testing), Intracytoplasmic sperm injection, donor eggs, and lifestyle changes, some other proven strategies that can improve Success rates for women over 40 are: . Using High-Quality Sperm: High-quality sperm can increase the chances of success with ICSI. In Vitro Fertilization, Sperm Cryobanking, and other services can also help with a successful pregnancy. . Combining ICSI with Assisted Hatching: Assisted hatching is a technique that can help embryos implant more successfully and increase the chances of a successful pregnancy.
What Other Factors Can Affect the Success Rate of ICSI?
. Male Factor Infertility Poor sperm motility, low sperm count, and abnormal sperm morphology are male infertility factors that can reduce the success rate of ICSI. Sometimes, male partners may need fertility treatments to improve their sperm quality. . Several Attempted Cycles The number of ICSI cycles can also affect the success rate. Women who have had several unsuccessful cycles may have a lower chance of success in subsequent cycles. . Other Health Factors Women with certain health conditions, such as autoimmune disorders or diabetes, may have a lower chance of success with ICSI. Women should discuss any underlying medical conditions with their fertility specialist or doctor before undergoing ICSI.