The Use of ICSI for Non-Male Factor Infertility: A Multicentre, Cross-Sectional Study

To assess patients' attitudes and preferences on the use of intracytoplasmic sperm injection (ICSI) for non-male factor infertility (NMFI) in in vitro fertilization (IVF).

A multicentre, cross-sectional, closed online survey was conducted across 3 large fertility centres between October 2019 and July 2024. Participants with a diagnosis of NMFI planning their first IVF treatment were randomly selected to participate. Participants were excluded from the study if they had a diagnosis of male factor infertility; were using a sperm and/or egg donor or planning preimplantation genetic testing; and/or were thawing previously cryopreserved oocytes.

A total of 123 participants (N = 123) were surveyed across all 3 centres. Most participants identified as female (95%) and were under the age of 35 years (50%). Before speaking with their physician, 59% of participants were already familiar with the different types of fertilization techniques, and 34% of them believed ICSI provided them with the best chances of having a child. Most participants did not have a personal, ethical, and/or religious contraindication to the use of ICSI (85%). Ultimately, most participants preferred their physician's recommendation (55%).

Our study indicates that the increased use of ICSI for NMFI does not appear to be driven by patients' attitudes or preferences. Fertility specialists should bear the responsibility of bridging the gap between our current practices and the existing evidence within the literature.