P-223 Comparison of blastocysts’ iDAScore® (intelligent Data Analysis-Score) if in vitro fertilization is performed using ICSI instead of IMSI
Authors: Sarandi S , Boumerdassi Y , Grynberg M , Sifer C 
Published: June 2023

Abstract

Study question
Does blastocysts’ iDAScore® differs when ICSI is performed instead of IMSI in case of teratozoospermia on the day of in vitro fertilization (D0)?

Summary answer
Blastocysts’ iDAScore® is unchanged when in ICSI or IMSI is performed in case of teratozoospermia at the day of fertilization (D0).

What is known already
In routine practice, IMSI for D0-teratozoospermia is sometimes not performed because of its higher cost and/or laboratory workload. Time-Lapse studies have shown that in vitro fertilization (IVF) using ICSI or IMSI in case of suboptimal sperm parameters lead to morphokinetically similar embryos. However, in patients with oligoasthenoteratozoospermia/teratozoospermia, evidence indicate that IMSI may improve embryo morphokinetics and further clinical outcomes. Since these studies rely on morphokinetical features assessed by an embryologist, the use of artificial intelligence may limit the human subjectivity for choosing the optimal blastocyst for transfer. Whether ICSI or IMSI for D0-teratozoospermia impact blastocysts’ iDAScore® has never been investigated.

Study design, size, duration
This retrospective monocentric study was performed between September 2021 and December 2022 in our reproductive medicine unit. A total of 605 oocytes (386 ICSI, 219 IMSI) from 58 patients (37 ICSI, 21 IMSI) were fertilized with fresh sperm using either ICSI or IMSI and then incubated for 5 days in Embryoscope8 (Vitrolife®) combined with iDAScore®. iDAScores® of 325 blastocysts (228 ICSI, 97 IMSI) were compared between IMSI and ICSI arms.

Participants/materials, setting, methods
For each couple 3 iDAScores® were available: i) mean iDAScore® of all blastocysts, ii) iDAScore® max, and iii) mean iDAScore® of useful blastocysts. These scores were compared according to the technique of IVF used (ICSI or IMSI). In addition, clinical pregnancy rates following blastocyst transfer were analyzed.
In all, 53 blastocyst transfers (34 ICSI, 19 IMSI) have been realized during fresh or frozen cycles. Clinical pregnancy rates were defined by presence of fetal heartbeat on ultrasound.

Main results and the role of chance
Patients in the ICSI and IMSI groups were comparable in terms of women age (32.3 ± 5.6 and 32.2 ± 5.6 years), BMI (24.9 ± 4.3 and 25 ± 4.3 Kg/m2, respectively). In addition, mean IVF rank was 1.4 ± 1.5 and 2.8 ± 1.5 in ICSI and IMSI couples. The number of mature oocytes inseminated per patient was similar in ICSI and IMSI groups (10.9 ± 4.7 and 10.4 ± 4.6, respectively), as well as the mean number of blastocysts per couple (6.4 ± 3.5 and 4.6 ± 3.5) and the blastoformation rate (0.74 ± 0.2 and 0.66 ± 0.2, respectively). The mean iDAScore® of all blastocysts, iDAScore® max and mean iDAScore® of useful blastocysts in women having undergone ICSI and IMSI were comparable (7.60 ± 1.2 vs. 7.63 ± 1.1 (p = 0.92); 8.80 ± 1.1 vs. 8.78 ± 1.0 (p = 0.67) and 8.1 ± 1.0 vs.7.96 ± 1 (p = 0.77) respectively). Finally, cumulated pregnancy rates (CPR) were not different between ICSI and IMSI groups (22/34 and 10/18 respectively), (0.65 ± 0.49 vs. 0.55 ± 0.46, respectively (p = 0.53)).

Limitations, reasons for caution
These results should be interpreted with caution due to the retrospective design of the study and small population.

Wider implications of the findings
We observed no difference in iDAScores whether ICSI or IMSI is performed in case of D0-teratozoospermia. Since IMSI is more time-consuming and more expensive, if these results are confirmed by further studies, we may withdraw this indication of IMSI to avoid patients bear additional fees, especially in private clinics.

Trial registration number
not applicable