Differentiated approach to the choice of oocyte fertilization method in assisted reproductive technology programs

DOI

https://dx.doi.org/10.18565/aig.2026.56

Bulatova V.A., Romanov A.Yu., Filimonov S.F., Dolgushina N.V., Nazarenko T.A.
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

In modern clinical practice, there has been an increase in the use of assisted reproductive technologies (ART). According to the 2023 report from the ART Registry of the Russian Association for Human Reproduction, the fertilization rate of oocytes using intracytoplasmic sperm injection (ICSI) is 58.3%, whereas in 2013 it was 52.1%, and in 2003 it was only 26.6%.
ICSI fertilization extends beyond indications related to male factor infertility, and is also observed among patients with borderline and normal semen parameters, despite the lack of convincing evidence of the advantage of oocyte fertilization using ICSI over conventional in vitro fertilization (IVF) in these groups, as well as the higher cost of this method.
There are currently numerous contradictory studies in the scientific literature regarding the method of oocyte fertilization in IVF programs for patients without male factor infertility. This does not make it possible to establish a standardized protocol for the management of these patients. It applies in particular to patients with unexplained infertility who are candidates for preimplantation genetic testing (PGT), women over 35 years old, and cycles in which fewer than four oocytes are retrieved, where there is no consensus on the optimal fertilization strategy.
Conclusion. The use of various fertilization techniques in ART programs in the absence of a significant male factor showed comparable embryological and clinical outcomes in women of advanced reproductive age, with a low number of retrieved oocytes, in cases of unexplained infertility, and in ART with planned PGT-A. ICSI is indicated to minimize the risk of contamination in PCR-based preimplantation genetic testing (PGT-M). Oocyte fertilization using ICSI entails additional financial costs. In the absence of improved clinical outcomes, this requires a more rigorous approach to determining indications.

Authors’ contributions. Romanov A.Yu., Nazarenko T.A., Dolgushina N.V. – developing the concept of the article and the design of the work; Bulatova V.A., Romanov A.Yu., Filimonov S.F. – analysis of the literature data; Bulatova V.A., Romanov A.Yu. – writing the text; Bulatova V.A., Romanov A.Yu., Filimonov S.F., Dolgushina N.V., Nazarenko T.A. – editing and final approval of the article.
Conflicts of interest. The authors declare no potential conflicts of interest related to the publication of this article.
Funding. The work was carried out as part of the PhD thesis by V.A. Bulatova on the topic ‘Improving the outcomes of assisted reproductive technology programs through a differentiated approach to oocyte fertilization’.
For citation: Bulatova V.A., Romanov A.Yu., Filimonov S.F., Dolgushina N.V., Nazarenko T.A.
Differentiated approach to the choice of oocyte fertilization method in assisted reproductive technology programs.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (5): 53-61 (in Russian)
https://dx.doi.org/10.18565/aig.2026.56

infertility

in vitro fertilization (IVF)

intracytoplasmic sperm injection (ICSI)

unexplained infertility

preimplantation genetic testing

advanced reproductive age

Full text (in Russian)

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Received 16.02.2026

Accepted 16.04.2026

Viktoriya A. Bulatova, PhD student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(909)066-15-95, viktoria_bulatova98@mail.ru, https://orcid.org/0000-0003-2992-4381
Andrey Yu. Romanov, PhD, Head of the Department of Planning and Support of Scientific Projects, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(903)158-94-00, a_romanov@oparina4.ru,
https://orcid.org/0000-0003-1821-8684
Sergey F. Filimonov, Embryologist at the F. Paulsen Research and Educational Center for ART with the Clinical Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(962)080-82-14,
s_filimonov@oparina4.ru
Nataliya V. Dolgushina, Professor, Dr. Med. Sci., Deputy Director for Research, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(495)438-49-77, n_dolgushina@oparina4.ru, https://orcid.org/0000-0003-1116-138X
Tatiana A. Nazarenko, Professor, Dr. Med. Sci., Director of the Institute of Reproductive Medicine, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(495)531-44-44, t_nazarenko@oparina4.ru,
https://orcid.org/0000-0003-4414-9942
Corresponding author: Andrey Yu. Romanov, a_romanov@oparina4.ru

Differentiated approach to the choice of oocyte fertilization method in assisted reproductive technology programs

Bulatova V.A., Romanov A.Yu., Filimonov S.F., Dolgushina N.V., Nazarenko T.A.

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