[The current role of intracytoplasmic single sperm injection (ICSI) in assisted reproduction]

Intracytoplasmic sperm injection (ICSI) plays a unique role in the treatment of male infertility. ICSI results are not influenced by either sperm number, motility or sperm morphology. In our group we studied 90 cycles in which conventional IVF and ICSI were performed on sibling oocytes in couples with borderline semen analysis (more than 50,000 sperm/oocyte). A higher number of A quality embryos was found in the ICSI oocyte group (40%/32%). In 38% of IVF cycles no embryos were found, whereas with ICSI the absence decreased to only 12%. In only 4% of the cycles, the IVF method was more successful than that of ICSI treatment. In only 7% of our combined group there were no embryos for transfer. The positive influence of ICSI on our centre results -32% pregnancy rate/ET and an 18% baby take home rate--are discussed. In our retrospective study, ICSI is more successful than IVF alone and a combination of IVF and ICSI achieves the best results in the borderline sperm analysis group. An increased use of the ICSI technique in assisted reproduction can be expected in future.