Fertilization rate and preimplantation development after intracytoplasmic sperm injection

Intracytoplasmic sperm injection (ICSI) is the treatment of choice in cases of male factor infertility. In the present review, all data from the literature regarding early fertlilization and preimplantation embryo development are analysed. ICSI seems to offer better fertilization rates than conventional IVF, even in the absence of a male factor and in prospective, randomized studies on sibling oocytes. Blastocyst formation is lower in ICSI than in IVF. This may be due to sublethal disturbances in oocyte architecture and function. Implantation and pregnancy rates, however, are similiar in ICSI and conventional IVF. Therefore, it can be concluded that ICSI offers a safe approach, as far as is known to date, for the treatment of male factor infertility. Embryo selection in cases of sublethal damage to oocytes seems to take place in the early preimplantation stages. Nor does the risk of monozygotic twinning, which was also proposed to be higher in ICSI compared with conventional IVF, seem to increase with this procedure.