Intracytoplasmic sperm injection increased fertilization and good-quality embryo formation in patients with non–male factor indications for in vitro fertilization: a prospective randomized study1

Objective: To compare the fertilization rate and formation of good-quality embryos with conventional IVF and ICSI in patients with non–male factor infertility.

Design: Prospective controlled study.

Setting: Infertility clinic.

Patient(s): Thirty-five patients with non–male factor infertility.

Intervention(s): Retrieved sibling oocytes were randomly assigned to conventional IVF or ICSI. Of sibling oocytes assigned to ICSI, only metaphase II oocytes were injected with sperm.

Main Outcome Measure(s): Fertilization rate and formation of good-quality embryos per retrieved oocyte.

Result(s): Per retrieved oocyte, ICSI resulted in better fertilization rate compared with conventional IVF (71.3% [134 of 188] vs. 57.2% [107 of 187]). Per retrieved oocyte, ICSI also resulted in better formation of good-quality embryos at 48 hours after retrieval compared with conventional IVF (64.4% [121 of 188] vs. 47.1% [88 of 187]).

Conclusion(s): In IVF patients with non–male factor infertility, subjecting some sibling oocytes to ICSI increased the fertilization rate and formation of good-quality embryos per retrieved oocyte. It also avoided the problem of total fertilization failure in almost all cases.