{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:01:45Z","timestamp":1788357705060,"version":"build-2803163510"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>The effectiveness of PIEZO-ICSI (P-ICSI) compared to conventional ICSI (C-ICSI) is still controversial. The only confirmed effectiveness of P-ICSI compared to C-ICSI is that it can reduce the number of degenerated oocytes after ICSI. This study included 100 patients undergoing their first IVF cycle. The patients were randomly assigned to C-ICSI group and P-ICSI group, 50 patients per each group. A total of 2,434 oocytes were retrieved from 100 patients. Among them, 1,527 oocytes with visible meiotic spindle were inseminated by C-ICSI or P-ICSI (778 by C-ICSI, 749 by P-ICSI). Fertilization, degeneration after ICSI and blastocyst development were compared between the C-ICSI group and P-ICSI group. Among the embryos developed to blastocysts, good quality blastocysts were vitrified. The frozen-thawed embryo transfer (FET) cycles were carried out in 42 patients of C-ICSI group and in 45 patients of P-ICSI group. Clinical pregnancy outcomes were analyzed. The differences between C-ICSI group and P-ICSI group were statistically analyzed using Mann-Whitney U test or chi-Square test. Patient age was not different between C-ICSI group and P-ICSI group (33.5\u2009\u00b1\u20092.7 vs. 32.9\u2009\u00b1\u20092.4, P\u2009=\u20090.12114). Normal fertilization rate of P-ICSI group (584\/749, 78.0%) was significantly higher than that of C-ICSI group (565\/778, 72.6%, P\u2009=\u20090.0176). The oocyte degeneration rate after ICSI was significantly higher in C-ICSI group (49\/778, 6.3%) than in P-ICSI group (24\/749, 3.2%, P\u2009=\u20090.0055). Among the fertilized oocytes, 21 did not cleave; 14 were from C-ICSI group (2.48%) and 7 from P-ICSI group (1.20%, P\u2009=\u20090.1250). Blastocyst formation rate (65.5% vs. 67.8%, P\u2009=\u20090.4485) and the rates of blastocyst that were available for vitrification (59.3% vs. 62.6%, P\u2009=\u20090.2724) were not different between C-ICSI group and P-ICSI group. Blastocyst formation rate on day 5 was significantly higher in P-ICSI group (50.3%) than in C-ICSI group (43.9%, P\u2009=\u20090.0367). In FET cycles, average age of patients was 33.6\u2009\u00b1\u20092.6 years old in C-ICSI group and that was 32.9\u2009\u00b1\u20092.3 years old in P-ICSI group. The average number of transferred embryos was 1.5\u2009\u00b1\u20090.5 in C-ICSI group and 1.2\u2009\u00b1\u20090.4 in P-ICSI group. The clinical pregnancy rate and the abortion rate of C-ICSI group were 64.3% and 18.5%, respectively. Those of P-ICSI group were 66.7% and 23.3%, respectively. This study showed that normal fertilization rate, the survival of oocytes after ICSI and blastocyst formation rate on day 5 were significantly higher in P-ICSI group than in C-ICSI group. Developmental arrest of zygotes was lower in P-ICSI group than in C-ICSI group. The number of embryos available for vitrification can be increased by implementing P-ICSI. P-ICSI has the potential to improve the development of zygotes into blastocysts.<\/jats:p>","DOI":"10.1371\/journal.pone.0330951","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T17:30:22Z","timestamp":1756488622000},"page":"e0330951","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of the clinical outcomes between conventional intracytoplasmic sperm injection (ICSI) and PIEZO-ICSI in women undergoing the first cycle of in-vitro fertilization"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9017-4612","authenticated-orcid":true,"given":"Chun Kyu","family":"Lim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Hee","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go-woon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwa Yeong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Jin","family":"Cha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Jae","family":"Ko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Ah","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyejin","family":"Ryu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Eun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyul","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3449-5425","authenticated-orcid":true,"given":"Wonyun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"issue":"8810","key":"pone.0330951.ref001","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/0140-6736(92)92425-F","article-title":"Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte","volume":"340","author":"G Palermo","year":"1992","journal-title":"Lancet"},{"issue":"3","key":"pone.0330951.ref002","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1001\/jama.2014.17985","article-title":"Trends in use of and reproductive outcomes associated with intracytoplasmic sperm injection","volume":"313","author":"SL Boulet","year":"2015","journal-title":"JAMA"},{"issue":"2","key":"pone.0330951.ref003","doi-asserted-by":"crossref","DOI":"10.1093\/hropen\/hox012","article-title":"Trends over 15 years in ART in Europe: an analysis of 6 million cycles","volume":"2017","author":"AP Ferraretti","year":"2017","journal-title":"Hum Reprod Open"},{"issue":"10284","key":"pone.0330951.ref004","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1016\/S0140-6736(21)00843-6","article-title":"Intracytoplasmic sperm injection versus conventional IVF","volume":"397","author":"SC Esteves","year":"2021","journal-title":"Lancet"},{"issue":"2","key":"pone.0330951.ref005","first-page":"194","article-title":"The ICSI procedure from past to future: a systematic review of the more controversial aspects","volume":"22","author":"P Rubino","year":"2016","journal-title":"Hum Reprod Update"},{"issue":"3","key":"pone.0330951.ref006","article-title":"ART in Europe, 2017: results generated from European registries by ESHRE","volume":"2021","author":"European IVF-Monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE)","year":"2021","journal-title":"Hum Reprod Open"},{"issue":"2","key":"pone.0330951.ref007","first-page":"139","article-title":"Physiological ICSI (PICSI) vs. Conventional ICSI in Couples with Male Factor: A Systematic Review","volume":"22","author":"G Avalos-Dur\u00e1n","year":"2018","journal-title":"JBRA Assist Reprod"},{"issue":"11","key":"pone.0330951.ref008","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1007\/s10815-013-0108-9","article-title":"A prospective randomized study to evaluate the effect of hyaluronic acid sperm selection on the intracytoplasmic sperm injection outcome of patients with unexplained infertility having normal semen parameters","volume":"30","author":"G Majumdar","year":"2013","journal-title":"J Assist Reprod Genet"},{"issue":"14","key":"pone.0330951.ref009","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1056\/NEJM200110043451416","article-title":"Selection of spermatozoa with normal nuclei to improve the pregnancy rate with intracytoplasmic sperm injection","volume":"345","author":"B Bartoov","year":"2001","journal-title":"N Engl J Med"},{"issue":"3","key":"pone.0330951.ref010","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s10815-015-0645-5","article-title":"Intracytoplasmic morphologically selected sperm injection (IMSI) does not improve outcome in patients with two successive IVF-ICSI failures","volume":"33","author":"N Gatimel","year":"2016","journal-title":"J Assist Reprod Genet"},{"issue":"11","key":"pone.0330951.ref011","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1093\/humrep\/deg447","article-title":"Meiotic spindle location and identification and its effect on embryonic cleavage plane and early development","volume":"18","author":"S Cooke","year":"2003","journal-title":"Hum Reprod"},{"issue":"6","key":"pone.0330951.ref012","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1093\/humrep\/deg274","article-title":"Relationship between meiotic spindle location with regard to the polar body position and oocyte developmental potential after ICSI","volume":"18","author":"L Rienzi","year":"2003","journal-title":"Hum Reprod"},{"issue":"3","key":"pone.0330951.ref013","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1093\/HUMREP\/11.3.540","article-title":"Two essential steps for a successful intracytoplasmic sperm injection: injection of immobilized spermatozoa after rupture of the oolema","volume":"11","author":"P Vanderzwalmen","year":"1996","journal-title":"Hum Reprod"},{"issue":"3","key":"pone.0330951.ref014","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1093\/humrep\/deh113","article-title":"Spindle imaging: a new marker for optimal timing of ICSI?","volume":"19","author":"Y Cohen","year":"2004","journal-title":"Hum Reprod"},{"issue":"4","key":"pone.0330951.ref015","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/S1472-6483(10)61996-7","article-title":"Spindle imaging in human oocytes: the impact of the meiotic cell cycle","volume":"12","author":"M Montag","year":"2006","journal-title":"Reprod Biomed Online"},{"issue":"5","key":"pone.0330951.ref016","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.rbmo.2017.06.015","article-title":"The Vienna consensus: report of an expert meeting on the development of ART laboratory performance indicators","volume":"35","author":"ESHRE Special Interest Group of Embryology and Alpha Scientists in Reproductive Medicine","year":"2017","journal-title":"Reprod Biomed Online"},{"issue":"4","key":"pone.0330951.ref017","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1002\/rmb2.12290","article-title":"Piezo-assisted ICSI improves fertilization and blastocyst development rates compared with conventional ICSI in women aged more than 35 years","volume":"18","author":"K Furuhashi","year":"2019","journal-title":"Reprod Med Biol"},{"issue":"3","key":"pone.0330951.ref018","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1159\/000052965","article-title":"Comparison of piezo-assisted micromanipulation with conventional micromanipulation for intracytoplasmic sperm injection into human oocytes","volume":"52","author":"S Takeuchi","year":"2001","journal-title":"Gynecol Obstet Invest"},{"issue":"2","key":"pone.0330951.ref019","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1093\/humrep\/14.2.448","article-title":"The usefulness of a piezo-micromanipulator in intracytoplasmic sperm injection in humans","volume":"14","author":"K Yanagida","year":"1999","journal-title":"Hum Reprod"},{"issue":"4","key":"pone.0330951.ref020","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1007\/BF02070146","article-title":"The use of piezo micromanipulation for intracytoplasmic sperm injection of human oocytes","volume":"13","author":"T Huang","year":"1996","journal-title":"J Assist Reprod Genet"},{"issue":"4","key":"pone.0330951.ref021","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1095\/biolreprod52.4.709","article-title":"Intracytoplasmic sperm injection in the mouse","volume":"52","author":"Y Kimura","year":"1995","journal-title":"Biol Reprod"},{"issue":"7","key":"pone.0330951.ref022","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1016\/S0093-691X(99)00213-7","article-title":"Efficient injection of bull spermatozoa into oocytes using a Piezo-driven pipette","volume":"52","author":"H Katayose","year":"1999","journal-title":"Theriogenology"},{"issue":"5","key":"pone.0330951.ref023","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1007\/s10815-018-1174-9","article-title":"Lower blastocyst quality after conventional vs. Piezo ICSI in the horse reflects delayed sperm component remodeling and oocyte activation","volume":"35","author":"RM Salgado","year":"2018","journal-title":"J Assist Reprod Genet"},{"issue":"3","key":"pone.0330951.ref024","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1262\/jrd.2018-119","article-title":"Development of feline embryos produced by Piezo-actuated intracytoplasmic sperm injection of elongated spermatids","volume":"65","author":"Y Tsujimoto","year":"2019","journal-title":"J Reprod Dev"},{"issue":"2","key":"pone.0330951.ref025","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1002\/rmb2.12324","article-title":"Evaluation of the effect of piezo-intracytoplasmic sperm injection on the laboratory, clinical, and neonatal outcomes","volume":"19","author":"Y Fujii","year":"2020","journal-title":"Reprod Med Biol"},{"issue":"12","key":"pone.0330951.ref026","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1007\/s10815-015-0597-9","article-title":"Clinical efficiency of Piezo-ICSI using micropipettes with a wall thickness of 0.625 \u03bcm","volume":"32","author":"K Hiraoka","year":"2015","journal-title":"J Assist Reprod Genet"},{"issue":"2","key":"pone.0330951.ref027","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s10815-022-02701-y","article-title":"PIEZO-ICSI increases fertilization rates compared with conventional ICSI in patients with poor prognosis","volume":"40","author":"M Caddy","year":"2023","journal-title":"J Assist Reprod Genet"},{"issue":"3","key":"pone.0330951.ref028","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.rbmo.2021.05.020","article-title":"PIEZO-ICSI increases fertilization rates compared with standard ICSI: a prospective cohort study","volume":"43","author":"D Zander-Fox","year":"2021","journal-title":"Reprod Biomed Online"},{"issue":"170","key":"pone.0330951.ref029","doi-asserted-by":"crossref","DOI":"10.3791\/60224","article-title":"Piezo-ICSI for Human Oocytes","author":"K Hiraoka","year":"2021","journal-title":"J Vis Exp"},{"issue":"1","key":"pone.0330951.ref030","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1002\/rcs.239","article-title":"Robust computer-controlled system for intracytoplasmic sperm injection and subsequent cell electro-activation","volume":"5","author":"KK Tan","year":"2009","journal-title":"Int J Med Robot"},{"issue":"4","key":"pone.0330951.ref031","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1109\/TBME.2010.2098875","article-title":"Automated sperm immobilization for intracytoplasmic sperm injection","volume":"58","author":"C Leung","year":"2011","journal-title":"IEEE Trans Biomed Eng"},{"issue":"7","key":"pone.0330951.ref032","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1007\/s10815-022-02485-1","article-title":"Fabrication on the microscale: a two-photon polymerized device for oocyte microinjection","volume":"39","author":"SH Yagoub","year":"2022","journal-title":"J Assist Reprod Genet"},{"issue":"3","key":"pone.0330951.ref033","doi-asserted-by":"crossref","first-page":"103237","DOI":"10.1016\/j.rbmo.2023.05.009","article-title":"First babies conceived with Automated Intracytoplasmic Sperm Injection","volume":"47","author":"N Costa-Borges","year":"2023","journal-title":"Reprod Biomed Online"},{"issue":"5","key":"pone.0330951.ref034","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1093\/humrep\/deq059","article-title":"Avoidance of weekend oocyte retrievals during GnRH antagonist treatment by simple advancement or delay of hCG administration does not adversely affect IVF live birth outcomes","volume":"25","author":"KP Tremellen","year":"2010","journal-title":"Hum Reprod"},{"issue":"6","key":"pone.0330951.ref035","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1016\/S0015-0282(16)49891-2","article-title":"Sperm morphologic features as a prognostic factor in in vitro fertilization","volume":"46","author":"TF Kruger","year":"1986","journal-title":"Fertil Steril"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0330951","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T17:30:26Z","timestamp":1756488626000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0330951"}},"subtitle":[],"editor":[{"given":"Wilfried A.","family":"Kues","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,8,29]]},"references-count":35,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,29]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0330951","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,29]]}}}