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Updated: May 16, 2026
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Published on: January 26, 2024
Intracytoplasmic sperm injection for non-male factor infertility does not improve cumulative live birth rate: a
Z M Ferraro1,2, L Meng3, K E Liu1,2
1Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada.
Purpose:
To determine whether intracytoplasmic sperm injection (ICSI) improves cumulative live birth rates (cLBR) compared with conventional IVF among patients with non-male factor infertility.
Methods:
This descriptive retrospective cohort study used linked Canadian Assisted Reproductive Technologies Registry (CARTR Plus) and Better Outcomes Registry & Network (BORN) data from 2013 to 2022. Outcomes were compared by insemination technique (IVF vs. ICSI). The primary outcome was cLBR per retrieval; secondary outcomes included normal fertilization (2PN), fertilization rate, utilizable embryos per retrieval, and cycles without live birth.
Results:
Among 140,252 retrieval cycles (35,251 IVF; 105,001 ICSI), cLBR was higher with conventional IVF (38.5% vs. 36.3%, p < 0.001). Oocyte yield was similar, although more oocytes were inseminated with IVF. Fertilization rates were slightly higher with ICSI, but normal fertilization and utilizable embryos per retrieval were comparable.
Conclusions:
In non-male factor infertility, ICSI does not improve cumulative live birth outcomes compared with conventional IVF.
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