Abstract:

Objective This study aims to explore the impacts of short-term insemination and early rescue intracytoplasmic sperm injection （E-RICSI） on clinical and neonatal outcomes for IVF patients. Methods A retrospective analysis was conducted on the clinical data from the patients who underwent fresh embryo transfer at the Reproductive Center from January 2019 to December 2023. Patients were divided into four groups based on fertilization method： short-term IVF group （n = 204）， conventional IVF group （n = 208）， E-RICSI group （n = 13） and conventional ICSI group （n = 92）. The fertilization rates， embryo development， pregnancy outcomes， and neonatal outcomes were compared between the short-term IVF and conventional IVF groups， and between the E-RICSI and conventional ICSI groups. Results There were no statistically significant differences in embryo development， clinical pregnancy， miscarriage， ectopic pregnancy， live birth rates， neonatal sex， and birth weight between the short-term IVF group and conventional IVF group. Similarly， no significant differences were observed in the E-RICSI group compared to the conventional ICSI group （P > 0.05）. However， the fertilization rate （79.11% vs. 84.39%， P < 0.001） and the rate of 2PN zygotes （63.98% vs. 70.83%， P < 0.001） were significantly lower in the short-term IVF group compared to the conventional IVF group； The fertilization rate （65.49% vs. 91.68%， P < 0.001） and the rate of 2PN zygotes （57.75% vs. 88.35%， P < 0.001） were significantly lower in the E-RICSI group compared to the conventional ICSI group. Conclusions Although the fertilization rate of short-term insemination and E-RICSI is lower than that of conventional IVF and ICSI， it has no effect on embryonic development， pregnancy outcome and neonatal outcome. Short-term insemination combined with early rescue ICSI is an effective and safe technology to prevent complete fertilization failure.

Key words: short-term insemination, early cumulus cell removal, clinical pregnancy rate, live birth rate