The status of controlled prospective clinical trials for efficacy of intracytoplasmic sperm injection in in vitro fertilization for non-male factor infertility

Purpose: Intracytoplasmic sperm injection (ICSI) of some sibling oocytes ma y have a beneficial effect in couples going through in vitro fertilization for causes of infertility not related to the male factor Our. purpose was t o critically appraise the randomized controlled studies done in this area a nd arrive at some recommendations. Methods: The four controlled trials done so far have utilized similar metho dology, i.e., they randomly allotted sibling oocytes to ICSI versus standar d insemination in patients going through in vitro fertiliztion and embryo t ransfer. Results: In the first trial reported in 1995 there was no difference in fer tilization rate, whereas the Inter trials reported in 1997, 1999, and 2000 showed improvement with ICSI that reached statistically significant level i n the last two studies. Conclusions: Total fertilization failure of an in vitro fertilization cycle can be prevented and fertilization can be improved if half of sibling oocy tes are subjected to ICSI.