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Unexplained InfertilityICSI/IVF-UINCT07294027

ICSI Versus Conventional IVF in Couples With Unexplained Infertility

A study testing ICSI and IVF in people with Unexplained Infertility, run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 7 sites in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

This multicenter, open-label, parallel-group, randomized controlled trial aims to compare the live birth rate, fertilization outcomes, other pregnancy outcomes and safety between ICSI and conventional IVF among couples with unexplained infertility in China. Read more about this study

Who is it for?
Ages 20 to 38 years, women only
Conditions the study is for
Unexplained Infertility
What is being tested?
ICSI and IVF
Could I receive a placebo?
No, everyone receives an active treatment
How many people
848 participants
Where
7 sitesChina
Study dates
1 Jan 2026to 30 Jul 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 38 years
  • Women only
  • No healthy volunteers
  • Adult

Who may be able to join

  • Aged 20-38 years
  • 18.5 < BMI < 24kg/m2
  • Couples diagnosed with primary unexplained infertility:
  • Regular menses or confirmed ovulation;
  • Normal ovarian reserve;
  • Patent fallopian tubes;
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  • Normal uterus and cervix;
  • Normal endocrine profile;
  • Semen analysis meeting WHO 6th edition criteria
  • Normal karyotypes in both partners, no family history of genetic disorders
  • First IVF/ICSI cycle
  • Received GnRH agonist protocol or GnRH antagonist protocol
  • Willing to provide informed consent and comply with follow-up

Who cannot join

  • Preimplantation genetic testing (PGT) cycles
  • In vitro maturation (IVM) cycles
  • Using donor sperm/oocyte
  • Using frozen sperm/oocyte
  • <5 oocytes retrieved
  • Abnormal semen parameters on the day of oocyte retrieval
Show all 11Show fewer
  • High risk of tubal pathology or endometriosis without laparoscopic exclusion
  • Untreated or poorly controlled endocrine disorders
  • Abnormal immune related examinations
  • Major organ/system disorders (cardiac, hepatic, renal, oncologic, hematologic, psychiatric, etc.)
  • Concurrent participation in other clinical trials.

Trial locations and contacts

7 sites in 1 country. Contact the study team or a site near you to ask about taking part.

7 sites in 1 country

China7 sites
  • Beijing Obstetrics and Gynecology Hospital, Capital Medical University

    Beijing, Beijing Municipality

    Xiaokui Yang, +86-010-52276699, yangxiaokui@ccmu.edu.cn

  • Second Affiliated Hospital, School of Medicine, Zhejiang University

    Hangzhou, Zhejiang, 310052

    Min Jin, +86-15925602121, min_jin@zju.edu.cn

  • Huangshi Central Hospital

    Huangshi, Hubei, 435000

    Junling Wang, +86-0714-3189999, wangjunling225969@163.com

  • Jiaxing Maternity and Child Health Care Hospital

    Jiaxing, Zhejiang, 314051

    Weiping Fu, +86-0573-82066132, fuweiping2816@163.com

  • Ningbo Women & Children's Hospital

    Ningbo, Zhejiang, 315012

    Liming Zhou, +86-0574-87083300, zhou.li.ming@163.com

  • Renmin Hospital of Wuhan University

    Wuhan, Hubei, 430060

    Qingzhen Xie, +86-027-88041911, rm001138@whu.edu.cn

  • Xiangyang Central Hospital

    Xiangyang, Hubei, 441021

    Xuezhou Yang, +86-0710-3520081, dryangxz@163.com

Other trials in China

About this study

Official title: Intracytoplasmic Sperm Injection (ICSI) Versus Conventional in Vitro Fertilization (IVF) in Couples With Unexplained Infertility: a Multicenter, Open-label, Parallel-group, Randomized Controlled Trial

This multicenter, open-label, parallel-group, randomized controlled trial aims to compare the live birth rate, fertilization outcomes, other pregnancy outcomes and safety between ICSI and conventional IVF among couples with unexplained infertility in China.

Read the detailed description

A multicenter, large-scale, randomized controlled clinical trial will enroll 848 couples with unexplained infertility undergoing their first cycle of IVF or ICSI. The study will recruit participants from 6 Reproductive Medical Centers across mainland China. The participation in this study will be approximately 1 years with a total of 9 visits from controlled ovarian hyperstimulation, pregnancy to delivery. On the day of oocyte retrieval, eligible participants will be allocated to either the ICSI group or the IVF group in a 1:1 ratio. All participants will be randomized through block randomization, and each center will enroll participants using a competitive enrollment method.

Being tested
ICSI, IVF
Keywords
Unexplained infertility, Conventional in vitro fertilization, Intracytoplasmic sperm injection

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ICSIProcedure or surgery

    Insemination will be performed by using ICSI, 2 hours after oocyte retrieval. COCs will be stripped by using hyaluronidase. Only matured oocytes (MII stage) will be injected. Fertilization check will be performed at period of 16-18 hours after injection.

    Other standard assisted reproductive treatments are similar and parallel between two groups.

  • IVFProcedure or surgery

    Insemination will be performed by using conventional IVF, 2-4 hours after oocyte retrieval. Collected COCs will be inseminated (1-5×105 sperm/ml) and cultured overnight in culture medium. Fertilization check will be performed at period of 16-18 hours after insemination.

    If the IVF group experiences total fertilization failure or a fertilization rate of less than 25%, late rescue ICSI (Late-RICSI) will be performed on all MII stage oocytes using semen retained on the day of egg retrieval. The injection method is same as standard ICSI.

    Other standard assisted reproductive treatments are similar and parallel between two groups.

Study groups in NCT07294027
Study groupRoleWhat they receive
Intracytoplasmic Sperm Injection (ICSI)Active comparatorAll patients will receive controlled ovarian hyperstimulation (COH) treatment, which is performed by standard routines at each study center. The COH treatment includes either GnRH agonist protocol or GnRH antagonist protocol. Oocyte retrieval is scheduled for 36 (±2) hours after hCG injection. The retrieved cumulus oocyte complexes (COCs) will be allocated to undergo ICSI procedure according to the result of randomization. The first embryo transfer is performed using fresh embryo transfer (if without contraindication), limited to transferring 1-2 cleavage embryos or 1 blastocyst. The remaining available embryos will be frozen.
Receives: Procedure: ICSI
Conventional in vitro fertilization (c-IVF)Active comparatorAll patients will receive controlled ovarian hyperstimulation (COH) treatment, which is performed by standard routines at each study center. The COH treatment includes either GnRH agonist protocol or GnRH antagonist protocol. Oocyte retrieval is scheduled for 36 (±2) hours after hCG injection. The retrieved cumulus oocyte complexes (COCs) will be allocated to undergo conventional IVF procedure according to the result of randomization. The first embryo transfer is performed using fresh embryo transfer (if without contraindication), limited to transferring 1-2 cleavage embryos or 1 blastocyst. If the embryos in the IVF group are fertilized through different methods (some with late-RICSI), the first embryo transfer is limited to embryos fertilized through conventional IVF. The remaining available embryos will be frozen.
Receives: Procedure: IVF

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Live birth rate after the first embryo transfer cycle

    Live birth is defined as the birth of at least one newborn after 24 weeks' gestation that exhibits any sign of life (twin will be a single count).

    Measured: At birth

Secondary outcomes (42)
  1. Cumulative ongoing pregnancy rate within one year

    Achieving ongoing pregnancy within 12 months after randomization, regardless of the number of embryo transfers performed (limited to embryos obtained in the current study).

    Ongoing pregnancy refers to the presence of a gestational sac and fetal heart beat after 12 weeks of gestation.

    Measured: At 12 weeks of gestation; At 12 months after randomization

  2. Number of retrieved oocyte

    Number of oocyte obtained on the day of oocyte retrieval

    Measured: 2 hours after oocyte retrieval

  3. MII rate

    [Only in ICSI group] The proportion of MII oocytes to the total number of retrieved oocytes.

    Measured: 2 hours after oocyte retrieval

  4. Fertilization rate per oocyte inseminated/injected

    The proportion of fertilized oocytes to inseminated oocytes (IVF group) / injected oocytes (ICSI group).

    Measured: At 16-18 hours after insemination or injection

  5. Fertilization rate per oocyte retrieved

    The proportion of fertilized oocytes to the total number of retrieved oocytes.

    Measured: At 16-18 hours after insemination or injection

  6. Normal fertilization rate

    Normal fertilization is defined as the appearance of 2PN

    Measured: At 16-18 hours after insemination or injection

  7. Abnormal fertilization rate

    Abnormal fertilization is defined as the appearance of 1PN or ≥3PN

    Measured: At 16-18 hours after insemination or injection

  8. Degeneration rate of ICSI oocytes

    [Only in ICSI group] The proportion of oocytes that undergo degeneration assessed on Day 2 among all oocytes receiving ICSI.

    Measured: At 16-18 hours after injection

  9. Cleavage rate

    The proportion of normal cleavage observed on Day 2 in normally fertilized oocytes

    Measured: At 16-18 hours after insemination or injection

  10. Day 2 embryo formation rate

    The proportion of 4-cell stage embryos formed on Day 2 compared to normal fertilized oocytes.

    Measured: 2 days after oocyte retrieval

  11. Day 3 embryo formation rate

    The proportion of 8-cell stage embryos formed on Day 3 compared to normal fertilized oocytes.

    Measured: 3 days after oocyte retrieval

  12. Good quality embryo rate on Day 3

    The proportion of I-II grade embryos with 6-10 cells on Day 3 compared to normal fertilized oocytes, according to Peter's scoring criteria.

    Measured: 3 days after oocyte retrieval

  13. Blastocyst formation rate

    The proportion of the number of blastocysts formed to the number of embryos undergoing blastocyst culture.

    Measured: 6 days after oocyte retrieval

  14. Good quality blastocyst formation rate

    The proportion of the number of blastocysts classified as 3BB or higher grade (according to Gardner scoring system) to the number of embryos undergoing blastocyst culture.

    Measured: 6 days after oocyte retrieval

  15. Good quality blastocyst rate

    The proportion of good quality blastocysts to the total number of blastocysts.

    Measured: 6 days after oocyte retrieval

  16. Number of available blastocyst

    Number of blastocysts of BC, CB grade and above, according to the Gardner scoring system.

    Measured: 6 days after oocyte retrieval

  17. Number of available embryo

    The total number of embryos that can be utilized for transplantation or cryopreservation.

    Measured: 6 days after oocyte retrieval

  18. Total fertilization failure rate

    Total fertilisation failure rate is defined as the absence of any zygotes with 2PN

    Measured: At 16-18 hours after insemination or injection

  19. Cycle cancellation rate

    The proportion of cycles with total fertilization failure or no available embryo to all oocyte retrieval cycles.

    Measured: 6 days after oocyte retrieval

  20. Moderate/severe ovarian hyperstimulation syndrome (OHSS)

    The exaggerated systemic response to ovarian stimulation. It is classified into mild, moderate, and severe based on the degree of bloating, ovarian volume enlargement, and respiratory, hemodynamic, and metabolic complications.

    Measured: At 10days after trigger; At 14 days after embryo transfer

  21. Positive pregnancy rate

    Positive pregnancy test is defined as a serum human chorionic gonadotropin level greater than 10mIU/mL after embryo transfer.

    Measured: 10-14 days after embryo transfer; At 12 months after randomization

  22. Clinical pregnancy rate

    Clinical pregnancy is defined as ultrasound detection of at least one gestational sac or other clear pregnancy manifestations under ultrasound (including clear ectopic pregnancy).

    Measured: 30 days after embryo transfer

  23. Implantation rate

    Implantation rate is defined as the number of gestational sacs per number of embryos transferred.

    Measured: 30 days after embryo transfer; At 12 months after randomization

  24. Ongoing pregnancy rate

    Ongoing pregnancy refers to the presence of a gestational sac and fetal heart beat after 12 weeks of gestation.

    Measured: At 12 weeks of gestation; At 12 months after randomization

  25. Ectopic pregnancy

    Ectopic pregnancy is defined as the presence of the gestational sac outside the uterine cavity detected by ultrasound.

    Measured: 30 days after embryo transfer; At 12 months after randomization

  26. Multiple pregnancy rate

    Multiple pregnancy is defined as the detection of two or more gestational sacs or positive heart beats by ultrasound.

    Measured: 30 days after oocyte retrieval; At 12 months after randomization

  27. Miscarriage rate

    Miscarriage refers to the loss of an intra-uterine pregnancy before 24 weeks of gestation.

    Measured: At 24 weeks of gestation; At 12 months after randomization

  28. Gestational diabetes mellitus

    Abnormal OGTT test

    Measured: At 24-28 weeks of gestation

  29. Hypertensive disorders of pregnancy

    The hypertensive disorders of pregnancy include gestational hypertension, chronic hypertension, pre-eclampsia, chronic hypertension with preeclampsia, eclampsia and HELLP syndrome.

    Measured: From 20 weeks of gestation up to at birth

  30. Antepartum haemorrhage

    Vaginal bleeding caused by placenta previa, placental implantation, or unknown reasons in mid or late pregnancy.

    Measured: From 20 weeks of gestation up to at birth

  31. Thrombotic diseases

    If the participant experiences clinical symptoms such as lower limb pain, chest pain, hemoptysis, etc., and there is a high suspicion of thrombotic disease in clinical practice, confirmation will be made through examinations such as vascular ultrasound and CT angiography.

    Measured: From 20 weeks of gestation up to 4-6 weeks after birth

  32. Gestational age at delivery

    Measured: At birth

  33. Preterm birth

    Pregnancy terminates after 28 weeks and before 37 weeks of gestation.

    Measured: At birth

  34. Spontaneous preterm birth

    Termination of pregnancy due to premature rupture of membranes or spontaneous uterine contractions between 28 to 37 weeks of gestation.

    Measured: At birth

  35. Iatrogenic preterm birth

    Termination of pregnancy due to iatrogenic factors between 28 to 37 weeks of gestation.

    Measured: At birth

  36. Birth weight

    Weight of newborn, classified as very low birth weight (<1500g), low birth weight (1500-2500g), macrosomia (>4000g).

    Measured: At birth

  37. Small for gestational age

    Birth weight below the 10th percentile for gestational age.

    Measured: At birth

  38. Large for gestational age

    Birth weight above the 90th percentile for gestational age.

    Measured: At birth

  39. Birth defect / Congenital anomaly

    Any birth defect or congenital anomaly will be included.

    Measured: At birth; At 4-6 weeks after birth

  40. NICU admission

    The admittance of the newborn to NICU.

    Measured: At 4-6 weeks after birth

  41. Perinatal mortality

    Fetal or neonatal death occurring after 28 weeks of gestation, during delivery, or within 7 days after birth.

    Measured: At 4-6 weeks after birth

  42. Neonatal mortality

    Death of a live born baby within 28 days of birth.

    Measured: At 4-6 weeks after birth

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Dec 2025
  2. Study start1 Jan 2026 (estimated)
  3. Primary completion30 Jul 2028 (estimated)
  4. Study completion30 Jul 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a multicenter study. Each center enrolls participants using a competitive enrollment method and performs online randomization through the trial system. Using block randomization with a 1:1 allocation ratio, participants were assigned to either the ICSI group or the IVF group, with a block length set at 8. The trial system administrators were not involved in the treatment process. Eligible patients who provided informed consent were registered in the trial system by medical staff at each center on the day of oocyte retrieval. After entering participant information, the system automatically assigned patients based on pre-set parameters.
Masking
None (open label)
Enrolment
848 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07294027
Sponsor's protocol ID
2025-0689
Acronym
ICSI/IVF-UI
Status last verified
Aug 2025
First submitted
27 Aug 2025
Last updated
19 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing ICSI and IVF in people with Unexplained Infertility, run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 7 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 19 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Min Jin, PhD (+86-15925602121, min_jin@zju.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Live birth rate after the first embryo transfer cycle (time frame: At birth). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Dec 2025; AzTrials last refreshed its copy on 31 Oct 2026.

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