Rescue intracytoplasmic sperm injection: a systematic review.

OBJECTIVE

To assess the feasibility, efficacy, and safety of rescue intracytoplasmic sperm injection (ICSI) in cases of fertilization failure, using a scientific literature search.

DESIGN

Systematic review.

SETTING

Centers for reproductive care.

PATIENT(S): Infertility patients with total or partial fertilization failure during an IVF cycle.

INTERVENTION(S): An electronic literature search was performed in PubMed from 1992 through May 2013. The search was then expanded by using listed references from selected articles.

MAIN OUTCOME MEASURE(S): Pregnancy rate. The secondary outcome measures were fertilization rate, normal fertilization rate, cleavage rate, birth rate, and malformation rate.

RESULT(S): Thirty-eight studies including 1,863 patients were included. The pooled pregnancy rate was 14.4%; 194 babies were delivered.

CONCLUSION(S): Rescue ICSI can result in the delivery of a healthy newborn, although the pregnancy rates are low. The clinical evidence did not indicate an elevated rate of malformations, although the data are limited and incomplete.