Rescue intracytoplasmic sperm injection: a systematic review.

Area of Science:

• Reproductive Medicine
• Infertility Treatment
• Assisted Reproductive Technologies

Background:

• Fertilization failure during in vitro fertilization (IVF) presents a significant challenge for couples undergoing fertility treatment.
• Rescue intracytoplasmic sperm injection (ICSI) has emerged as a potential strategy to salvage cycles with failed fertilization.
• Assessing the outcomes of rescue ICSI is crucial for reproductive endocrinologists and patients facing such scenarios.

Purpose of the Study:

• To evaluate the feasibility, efficacy, and safety of employing rescue intracytoplasmic sperm injection (ICSI) in cases of complete or partial fertilization failure during an IVF cycle.
• To synthesize existing scientific literature to provide evidence-based insights into the success rates and potential risks associated with rescue ICSI.
• To inform clinical decision-making for patients experiencing fertilization issues in assisted reproductive technology (ART).

Main Methods:

• A systematic review of scientific literature was conducted.
• An extensive electronic literature search was performed using PubMed, covering publications from 1992 to May 2013.
• References from selected articles were reviewed to broaden the search scope, identifying 38 relevant studies involving 1,863 patients.

Main Results:

• The pooled pregnancy rate following rescue ICSI was 14.4%.
• A total of 194 babies were delivered from the included studies.
• The analysis did not reveal an elevated rate of malformations, but acknowledged limitations in the available data.

Conclusions:

• Rescue ICSI can lead to the successful delivery of healthy newborns, even in cases of prior fertilization failure.
• While pregnancy rates remain modest, the procedure appears safe concerning malformation rates, although further research with larger datasets is warranted.
• This systematic review supports the consideration of rescue ICSI as a viable option for specific infertility cases, emphasizing the need for careful patient selection and counseling.