A Randomized Controlled Trial Comparing Intracytoplasmic Sperm Injection and Conventional <i>In Vitro</i> Fertilization Outcomes in Patients With Advanced Maternal Age
Bibliographic record
Abstract
Background: The most widely used fertilization treatment globally is intracytoplasmic sperm injection (ICSI), which is now indicated for a broader range of conditions. This study was designed to assess the outcomes of ICSI and conventional in vitro fertilization (c-IVF) specifically in advanced maternal age (AMA) patients. Methods: This randomized controlled study included 70 women aged 39 - 44 years with a body mass index (BMI) of 18 - 35 kg/m2 and partners with normal semen parameters. After informed consent, each patient’s ovaries were randomized before stimulation: oocytes from one ovary (n = 250) underwent ICSI, and those from the other (n = 250) underwent conventional IVF. Results: The average daily gonadotropin dose was 351.5 IU, with ovarian stimulation lasting about 9.7 days. Baseline follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were 9.1 and 4.9 IU/L, respectively. Semen parameters included a volume of 2.1 mL, concentration of 72.5 million/mL, 59.7% motility, and 5.2% normal morphology. An average of 7.1 oocytes were retrieved per patient. In the ICSI and c-IVF groups, 71.2% and 72.4% of oocytes formed zygotes, with similar cleavage and top-quality embryo rates. Embryo transfers occurred in 54.8% (ICSI) and 57.6% (c-IVF) of cases. No substantial disparities were detected between the groups concerning their clinical and ongoing pregnancy rates. Conclusions: In women aged 39 - 44 with normal sperm parameters, this study found no substantial variation in fertilization, embryo quality, or pregnancy rates between ICSI and c-IVF. Thus, ICSI offers no clear advantage over c-IVF in this population, suggesting that c-IVF remains a viable and effective option for patients with AMA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".