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Human Reproduction, Vol. 16, No. 12, 2485-2490, December 2001
© 2001 European Society of Human Reproduction and Embryology

Debates continued

Should ICSI be the treatment of choice for all cases of in-vitro conception?

Considerations of fertilization and embryo development, cost ffectiveness and safety

Bolarinde Ola, Masoud Afnan, Khaldoun Sharif, Spyros Papaioannou, Nahed Hammadieh and Christopher L.R.Barratt,1

Assisted Conception Unit, Birmingham Women's Hospital, Edgbaston, Birmingham B15 T2G, UK

There is now considerable discussion whether intracytoplasmic sperm injection (ICSI) should be used in all cases of IVF. A critical and balanced view of the current literature is presented. The difficult question is how to identify men with apparently normal semen who are likely to fail to achieve a pregnancy using IVF. In conclusion, from both the safety and scientific viewpoint, ICSI should only be used in cases where success at IVF is regarded as unlikely.

Key words: budget impact analysis/cost needed to treat/fertilization failure/intracytoplasmic sperm injection (ICSI)/number needed to treat

1 To whom correspondence should be addressed. E-mail: c.l.barratt{at}bham.ac.uk

Note added at proof

After completion of this manuscript Bhattacharya and colleagues reported on a trial comparing ICSI and IVF in non-male factor and mild male factor infertility. Although live birth rates were not reported, implantation rates were similar between the two groups (Battacharya et al., 2001).


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