OBJECTIVE To determine whether intracytoplasmic sperm injection (ICSI) is associated with improved outcomes compared with conventional in vitro fertilization (IVF) for patients with nonsevere male factor infertility. DESIGN Retrospective cohort. SETTING University-affiliated reproductive endocrinology unit. PATIENT(S) Couples who received their first-cycle embryo transfer without severe oligoasthenozoospermia (OA) between January 2012 and December 2016 were included in this study. INTERVENTION(S) Six subgroup analyses were performed according to the proposed indications for the use of ICSI as follows: non-male factor infertility, advanced maternal age (≥38 years), unexplained infertility, low oocyte yield (≤6), mild OA, and moderate OA. MAIN OUTCOME MEASURE(S) Live birth rates and selected perinatal outcomes. RESULT(S) ICSI resulted in live birth rates similar to those achieved with IVF (41.68% vs. 44.31%). There were no significant differences in the incidences of gestational diabetes mellitus, hypertension disorder of pregnancy, placental previa, postpartum hemorrhage, cesarean delivery, fetal macrosomia, small for gestational age, large for gestational age, neonatal intensive care unit (NICU) admission, and congenital anomalies between the two groups. Subgroup analyses showed that ICSI resulted in a lower rate of NICU admission in couples with moderate OA. CONCLUSION(S) Our results suggested that routine use of ICSI for all causes of infertility did not result in better pregnancy and perinatal outcomes compared with conventional IVF in the first cycle. ICSI might be associated with a lower risk of NICU admission when used in couples with moderate OA. Large prospective studies are required to validate our current findings.

中文翻译：

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非严重男性不育夫妇卵胞浆内单精子注射与传统体外受精的产科和围产期结果

目的 确定与传统体外受精 (IVF) 相比，对于非严重男性因素不孕症患者，卵胞浆内单精子注射 (ICSI) 是否与改善的结果相关。设计回顾性队列。设置 大学附属生殖内分泌科。本研究纳入了在 2012 年 1 月至 2016 年 12 月期间接受第一周期胚胎移植但没有严重少弱精子症 (OA) 的患者夫妇。干预（S） 根据使用 ICSI 的建议适应症进行了六个亚组分析，如下所示：非男性因素不孕、高龄产妇（≥38 岁）、原因不明的不孕、卵母细胞产量低（≤6）、轻度 OA和中度 OA。主要结局指标活产率和选定的围产期结局。结果 ICSI 的活产率与 IVF 相似（41.68% 对 44.31%）。妊娠期糖尿病、妊娠期高血压疾病、前置胎盘、产后出血、剖宫产、巨大胎儿、小于胎龄儿、大于胎龄儿、新生儿重症监护病房（NICU）入院和产后出血的发生率无显着差异。两组之间的先天性异常。亚组分析表明，ICSI 导致中度 OA 夫妇的 NICU 入住率较低。结论（S） 我们的结果表明，与第一周期的常规 IVF 相比，常规使用 ICSI 治疗所有原因的不孕症并未带来更好的妊娠和围产期结局。ICSI 可能与中度 OA 夫妇使用 NICU 的风险较低有关。需要大型前瞻性研究来验证我们目前的发现。