Purpose To determine whether intracytoplasmic sperm injection (ICSI) improves cumulative live birth rates (cLBR) compared with conventional IVF among patients with non–male factor infertility. Methods This descriptive retrospective cohort study used linked Canadian Assisted Reproductive Technologies Registry (CARTR Plus) and Better Outcomes Registry Network (BORN) data from 2013 to 2022. Outcomes were compared by insemination technique (IVF vs. ICSI). The primary outcome was cLBR per retrieval; secondary outcomes included normal fertilization (2PN), fertilization rate, utilizable embryos per retrieval, and cycles without live birth. Results Among 140,252 retrieval cycles (35,251 IVF; 105,001 ICSI), cLBR was higher with conventional IVF (38.5% vs. 36.3%, p 0.001). Oocyte yield was similar, although more oocytes were inseminated with IVF. Fertilization rates were slightly higher with ICSI, but normal fertilization and utilizable embryos per retrieval were comparable. Conclusions In non–male factor infertility, ICSI does not improve cumulative live birth outcomes compared with conventional IVF.
Ferraro et al. (Wed,) studied this question.