The ICSI procedure was invented to treat severe male infertility but is often used even if the sperm quality parameters are normal. This practice has recently been called into question, but there is still no clear answer especially in terms of sperm morphology, regarding when it is necessary to perform ICSI and when conventional IVF is indeed more beneficial. In borderline cases it seems logical to fertilize oocytes using ICSI and conventional IVF at the same time. Since we also use this approach we performed a retrospective analysis of such cycles to elucidate, which procedure results in a better clinical outcome in terms of fertilization rate, the quality of day 3 and day 5 embryos, and the pregnancy rate. The data from fifty-one couples who were treated with ART and whose male factor of infertility was defined as teratozoospermia were included. The fertilization rates were similar between ICSI and conventional IVF groups (per COCs: 54.5% vs. 58.2%, P = 0.322; per MII oocytes: 63.9% vs. 67.2%; P = 0.399), but more oocytes degenerated after ICSI (11.7% vs. 4.3%; P = 0.0003). The quality of cleaved embryos was similar between the groups, but more embryos reached the blastocyst stage after conventional IVF (43.7% vs. 55.0%; P = 0.032) and furthermore, more of them were of good quality (19.8% vs. 29.2%; P = 0.037). The pregnancy rate did not significantly differ between the groups (21.4% vs. 45.5%; P = 0.175), although there was a trend in favor of conventional IVF. This retrospective analysis suggests that when sperm morphology is not severely impaired and sperm concentration and motility are normal, it is better to use conventional IVF to fertilize oocytes and not ICSI. The main advantage of conventional IVF is reflected in improved blastocyst rate and quality.

Abbreviations: ICSI: intracytoplasmic sperm injection; IVF: in vitro fertilization; COC: cumulus-oocyte complex; COH: controlled ovarian hyperstimulation

发明了ICSI程序可治疗严重的男性不育症，但即使精子质量参数正常也经常使用。这种做法最近受到质疑，但是，关于何时需要进行ICSI，何时进行常规IVF确实更有益，尤其是在精子形态方面仍没有明确的答案。在临界情况下，同时使用ICSI和常规IVF使卵母细胞受精似乎是合乎逻辑的。由于我们也使用这种方法，因此我们对这些周期进行了回顾性分析，以阐明受精率，第3天和第5天胚胎的质量以及怀孕率方面的临床结果。包括来自接受ART治疗且男性不育因素定义为畸胎性精子症的51对夫妇的数据。ICSI和常规IVF组之间的受精率相似（每个COC：54.5％对58.2％，P = 0.322；每个MII卵母细胞：63.9％对67.2％； P = 0.399），但ICSI后变性的卵母细胞更多（11.7 ％对4.3％； P = 0.0003）。两组之间卵裂的质量相似，但是常规IVF后进入胚泡期的胚胎更多（43.7％vs. 55.0％； P = 0.032），此外，它们的质量更好（19.8％vs 29.2％）。 ； P = 0.037）。两组之间的妊娠率没有显着差异（21.4％vs. 45.5％； P = 0.175），尽管有倾向于传统IVF的趋势。这项回顾性分析表明，当精子形态没有受到严重损害并且精子浓度和运动力正常时，最好使用常规的IVF来使卵母细胞受精而不是ICSI。

缩写：ICSI：胞浆内精子注射；试管婴儿：体外受精；COC：卵-卵母细胞复合体；COH：控制性卵巢过度刺激