The role of ICSI vs. conventional IVF for patients with advanced maternal age—a randomized controlled trial

Jigal Haas, Tal Elkan Miller, Ravit Nahum, Adva Aizer, Michal Kirshenbaum, Eran Zilberberg, Oshrit Lebovitz, Raoul Orvieto

Research output: Contribution to journalArticlepeer-review


Objectives: This study aimed to evaluate the role of intracytoplasmic sperm injection (ICSI) in the treatment of non-male factor infertile patients aged ≥ 39. Methods: This is a single-center, prospective, randomized controlled clinical trial, between March 2018 and December 2019. Sixty-nine patients were recruited, and sixty patients participated in the study. Their ovaries were randomized prior to the beginning of the ovarian stimulation: the oocytes from one side (n = 257) were allocated to the ICSI (ICSI arm), while those of the contralateral side (n = 258) were allocated to conventional insemination (IVF arm). The fertilization rate per oocyte retrieved, number of zygotes (2PN), and cleavage-stage embryos were assessed and compared between the two study groups. Results: The average number of zygotes (3.1 vs. 2.7 p = 0.45), the fertilization rate (72.4% vs. 65.1% p = 0.38), the average number of cleavage-stage (2.8 vs. 2.4 p = 0.29), and the average top-quality embryos (TQE) cleavage-stage embryos (1.7 vs. 1.6 p = 0.94) were comparable between the two groups. The TQE rate per randomized oocyte (41.2% vs. 41% p = 0.8) was also similar in both groups. Conclusions: ICSI does not improve the reproductive outcomes of advanced-age patients undergoing conventional insemination for non-male factor infertility. Trial registration: NCT03370068.

Original languageEnglish
Pages (from-to)95-100
Number of pages6
JournalJournal of Assisted Reproduction and Genetics
Issue number1
StatePublished - Jan 2021


  • Advanced maternal age
  • Conventional IVF
  • ICSI


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