AUTHOR=Huang Jun-Xia , Gao Yu-Qi , Chen Xiao-Tong , Han Ying-Qi , Song Jing-Yan , Sun Zhen-Gao 

TITLE=Impact of intracytoplasmic sperm injection in women with non-male factor infertility: A systematic review and meta-analysis

JOURNAL=Frontiers in Reproductive Health

VOLUME=4

YEAR=2022

URL=https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2022.1029381

DOI=10.3389/frph.2022.1029381

ISSN=2673-3153

ABSTRACT=<sec><title>Objective</title><p>The purpose of this study is to determine whether intracytoplasmic sperm injection (ICSI) is beneficial in patients with non-male factor infertility.</p></sec><sec><title>Methods</title><p>This systematic review and meta-analysis included articles from inception to May 2022. Published studies of non-male factor infertile women undergoing ICSI or <italic>in vitro</italic> fertilization (IVF) included in PubMed, Embase, web of science, Wanfang Database, and CNKI were searched by computer, without language restrictions. A random-effect model was applied to calculate the risk ratios (RRs) and their 95% confidence intervals (CIs). Letters, case reports, and review articles including meta-analyses and expert opinions were excluded. The primary endpoints were laboratory outcomes and pregnancy outcomes. The Secondary endpoints were neonatal outcomes.</p></sec><sec><title>Results</title><p>Six randomized controlled studies and 20 retrospective cohort studies met the inclusion criteria. In meta-analytic forest plots, compared with IVF, those who received ICSI treatment were not different in fertilization rate (RR = 0.99, 95% CI [0.90–1.09], <italic>P</italic> = 0.88), total fertilization failure rate (RR = 1.30, 95% CI [1.17–1.45], <italic>P</italic> &lt; 0.00001), and good quality embryo rate (RR = 0.94, 95% CI [ 0.86–1.02], <italic>P</italic> = 0.15), clinical pregnancy rate (RR = 0.84, 95% CI [0.70–1.01], <italic>P</italic> = 0.06), live birth rate (RR = 0.89, 95% CI [0.77–1.03], <italic>P</italic> = 0.13), miscarriage rate (RR = 1.06, 95% CI [0.78–1.43], <italic>P</italic> = 0.71), preterm neonatal delivery rate (RR = 0.92, 95% CI [0.67–1.26], <italic>P</italic> = 0.61), and low neonatal weight rate (RR = 1.13, 95% CI [0.80–1.61], <italic>P</italic> = 0.48). However, the implantation rate of IVF was better than ICSI (RR = 0.77, 95% CI [0.64–0.93], <italic>P</italic> = 0.005). In the subgroup analysis of the live birth rate of fresh embryo transfer, IVF performed in those ≥35 years had a higher live birth rate (RR = 0.82, 95% CI [0.78–0.83], <italic>P</italic> &lt; 0.001).</p></sec><sec><title>Conclusion</title><p>The findings of this study indicate that ICSI is not superior to IVF in the treatment of infertility related to non-male factors. In order to confirm this result, more high-quality clinical studies are needed.</p></sec>