IVF preferred to ICSI for non-male factor infertility

Cindy Farquhar

In vitro fertilisation (IVF) can be used to treat couples with unexplained infertility or female infertility caused by damaged fallopian tubes.  With IVF, one egg is inseminated with approximately 50,000 spermatazoa.  For some couples undergoing IVF, the egg does not become fertilised - either because of defective sperm or poor interaction between the sperm and egg.

Assisted fertilisation techniques have been developed to help couples with male factor infertility.  These techniques do not treat the basic sperm defect, but improve the chances of conceiving without having to use donor sperm.  Intra-cytoplasmatic sperm injection (ICSI) is an assisted fertilisation technique whereby a single sperm is injected into an egg, increasing the likelihood of fertilisation.  ICSI has become a proven treatment for couples with severe male factor infertility.  It may also benefit couples with unexplained infertility or tubal disease where repeated IVF treatment has not resulted in fertilisation.

This review of trials compared the pregnancy and live birth rates between IVF and ICSI for couples with non-male factor infertility.  The review found that IVF gives better fertilisation results than ICSI for these couples, and that pregnancy rates after IVF and ICSI are not significantly different.  ICSI does not improve on the IVF outcome for these couples; IVF should be the preferred treatment because it is less expensive and less complicated.  In addition, there is some concern about the risk of birth defects and child development as a result of ICSI.  Until the long-term consequences of ICSI are known, IVF should be the treatment of choice for couples with non-male factor infertility.

To read the full Cochrane Review, please click on the Link