ALWAYS ICSI? A SWOT analysis

Purpose: Intracytroplasmatic sperm injection (ICSI) is a common procedure used to improve reproductive results, even among couples without male factor infertility. However, the evidence available is still uncertain on the possible advantages and deficiencies that this procedure may have in patients...

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Bibliographic Details
Authors: Bosch, Ernesto, Espinós, Juan José|||0000-0003-4838-8940, Fabregues, Francisco, Fontes, J, García-Velasco, Juan A.|||0000-0003-1005-8727, Llácer, Joaquín, Requena, Antonio, Checa, Miguel Angel|||0000-0002-0226-3416, Bellver, José
Format: article
Publication Date:2020
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:318341
Online Access:https://ddd.uab.cat/record/318341
https://dx.doi.org/urn:doi:10.1007/s10815-020-01836-0
Access Level:Open access
Keyword:Assisted reproduction
In vitro fertilization (IVF)
Infertility
Intracytoplasmic sperm injection (ICSI)
Pregnancy
Severe non-male factor
Description
Summary:Purpose: Intracytroplasmatic sperm injection (ICSI) is a common procedure used to improve reproductive results, even among couples without male factor infertility. However, the evidence available is still uncertain on the possible advantages and deficiencies that this procedure may have in patients with no formal indication for ICSI. Methods: A SWOT (strengths, weaknesses, opportunities, threats) analysis examines the possible advantages and deficiencies of performing ICSI in these patients with no formal indication. Results: The evidence suggests that ICSI is not justified for non-male factor infertile couples requiring in vitro conception. One of the major strengths associated to the procedure is the virtual elimination of cases further complicated by total fertilization failure and a combination between IVF and ICSI on sibling oocytes has been advised in the literature. Greater technical difficulties, higher costs and performing an unnecessary invasive technique in some cases represent some of the weaknesses of the procedure, and questions regarding safety issues should not be ruled out. Conclusion: Despite the widespread use of ICSI in patients without a formal diagnosis of male factor infertility, evidence demonstrating its effectiveness in this population is still lacking. Additional large and well-designed randomized controlled trials are needed to clarify definitive indications for ICSI in non-male factor infertility.