Intracytoplasmic sperm injection increased fertilization and good-quality embryo formation in patients with non–male factor indications for in vitro fertilization: a prospective randomized study

Comparison of embryo quality between intracytoplasmic sperm injection and in vitro fertilization in sibling oocytes

“…Similar results were demonstrated by Hsu et al [6] and Frattarelli et al [7]. Others, however, found embryo quality to be comparable between the two methods [3,[8][9][10][11][12][13], or even superior in ICSI [2,14,15].…”

“…Verheyen and his colleagues demonstrated similar results in 20 couples with relative male factor infertility (failed fertilization rates of 0 vs. 50%) [11]. Piskara et al [9], Staessen et al [10] and Khamsi et al [15] demonstrated a similar trend towards lower rates of total fertilization failure in ICSI than IVF. Reported rates ranged between 10 to 27.8% for IVF vs. 0-5.5% for ICSI.…”

“…However, there was no significant difference in the formation of good-quality embryos per fertilized oocyte. These findings indicate that ICSI does not improve or diminish the formation of good embryos; rather, the difference between IVF and ICSI in good embryoformation per oocyte was related to the better fertilization rate obtained with ICSI [15]. Yang et al [14] found that more grade A embryos were obtained by ICSI than by conventional IVF performed on sibling oocytes.…”

“…In a recent study using sibling oocytes from 35 couples with non-male-factor infertility, Khamsi and colleagues [15] demonstrated increased formation of good-quality embryos per retrieved oocyte after ICSI than after conventional IVF (64.4 vs. 47.1%, respectively). However, there was no significant difference in the formation of good-quality embryos per fertilized oocyte.…”

Should ICSI be recommended routinely in patients with four or fewer oocytes retrieved?

“…An association between lower number of retrieved oocytes and lower fertilization rates and IVF outcome has been described [12,13]. Additionally, fertilization failure is a common finding when less than 3 oocytes are retrieved [14] The high fertilization rates, small numbers of fertilization failures, and lack of apparent long term drawbacks make ICSI an appealing solution for IVF [15,16]. Hence, it has been proposed that ICSI could improve fertilization rates and the likelihood of successful embryo transfer when the number of recovered oocytes is low [17].…”