[IMSI versus ICSI for male factor infertility: A meta-analysis]

Area of Science:

• Reproductive Medicine
• In Vitro Fertilization
• Male Infertility

Background:

• Male factor infertility is a significant cause of couples seeking assisted reproductive technologies.
• Intracytoplasmic sperm injection (ICSI) is a common technique used in in vitro fertilization (IVF).
• Intracytoplasmic morphologically selected sperm injection (IMSI) is a modification of ICSI, utilizing higher magnification for sperm selection.

Purpose of the Study:

• To compare the efficacy and safety of IMSI versus ICSI in IVF for couples experiencing male factor infertility.
• To evaluate key outcomes such as live birth rate and clinical pregnancy rate.

Main Methods:

• A systematic review and meta-analysis were conducted following Cochrane guidelines.
• Searches included major databases (MEDLINE, EMBASE, CENTRAL, etc.) and reference lists of relevant studies.
• Eight randomized controlled trials (RCTs) comparing IMSI and ICSI were included in the analysis.

Main Results:

• No significant difference in live birth rate was observed between IMSI and ICSI in pure male factor infertility (very low quality evidence).
• IMSI was associated with an increased clinical pregnancy rate in cases of accompanying male factors (low quality evidence).
• No significant difference in live birth or clinical pregnancy rates was found for accompanying male factors in other analyses (low to moderate quality evidence).

Conclusions:

• The current evidence regarding IMSI's effect on clinical pregnancy rates is of low quality.
• The data is insufficient to recommend the routine adoption of IMSI in IVF protocols for male factor infertility.
• Further high-quality research is needed to definitively establish the role of IMSI.