Should ICSI (Intracytoplasmic Sperm Injection) be applied in all IVF procedures ?
A recent report in the journal ‘Human Reproduction’ raised the question as to whether we had reached the stage when microinjection was the ‘preferred method’ for fertilizing the human egg. Simon Fishel in a multi centre study involving colleagues from Nottingham (UK), Italy and South Africa examined the different clinican scenarios of IVF by comparing conventional IVF, high insemination concentration (HIC) and intracytoplasmic injection (ICSI) in several group of patients. Their study covered a 5 year period from 1994 -1998 with 221 patients in this prospective randomized trial. Patients were selected at random. Their studies showed that in the absence of Male factor problems the incidences of fertilization after conventional IVF and ICSI were comparable. The authors do suggest however that ICSI “offers the advantage of bypassing the barriers” responsible for any block in fertilisation which may be of oocyte (egg) origin and especially spermatozoan origin, and that the risk of complete
