IVF best when one egg available

For infertile couples undergoing assisted reproduction when only a single egg is retrieved, a conventional in vitro fertilisation (IVF) approach is adequate when semen quality is good. In fact, semen quality is the most important determinant when considering which fertilisation technique to use. The choice is between intracytoplasmic sperm injection (ICSI), in which a single sperm is injected into the egg under a microscope, or conventional in vitro fertilization (IVF), which essentially places the egg with semen in a test tube. Researchers from the Chaim Sheba Medical Center, Tel Hashomer, Israel, compared the success rate of ICSI and conventional IVF with a single egg in couples with good and poor sperm quality. For patients younger than age 39 years with favourable semen quality, ICSI and standard IVF produced statistically similar fertilisation rates and pregnancy rates. In this age group when semen quality was lower, ICSI produced a significantly higher fertilisation rate than IVF, but not a significant difference in pregnancy rate. The results were basically similar in patients older than age 39, except that pregnancy rates were higher with ICSI when semen quality was low. The researchers pointed out that when dealing with subfertile sperm, it is well established that implementation of ICSI is recommended. However, when sperm characteristics are normal, conflicting viewpoints are found in the literature regarding the benefit of ICSI. It was concluded that there is no benefit to using ICSI in patients with good quality semen.