IVI RMA Valencia, Plaza de la Policía Local, 3, 46015, Valencia, Spain.
Fertty, Ausiàs March 25, 08010, Barcelona, Spain.
J Assist Reprod Genet. 2020 Sep;37(9):2081-2092. doi: 10.1007/s10815-020-01836-0. Epub 2020 Jun 24.
Intracytroplasmatic sperm injection (ICSI) is a common procedure used to improve reproductive results, even among couples without male factor infertility. However, the evidence available is still uncertain on the possible advantages and deficiencies that this procedure may have in patients with no formal indication for ICSI.
A SWOT (strengths, weaknesses, opportunities, threats) analysis examines the possible advantages and deficiencies of performing ICSI in these patients with no formal indication.
The evidence suggests that ICSI is not justified for non-male factor infertile couples requiring in vitro conception. One of the major strengths associated to the procedure is the virtual elimination of cases further complicated by total fertilization failure and a combination between IVF and ICSI on sibling oocytes has been advised in the literature. Greater technical difficulties, higher costs and performing an unnecessary invasive technique in some cases represent some of the weaknesses of the procedure, and questions regarding safety issues should not be ruled out.
Despite the widespread use of ICSI in patients without a formal diagnosis of male factor infertility, evidence demonstrating its effectiveness in this population is still lacking. Additional large and well-designed randomized controlled trials are needed to clarify definitive indications for ICSI in non-male factor infertility.
胞质内精子注射（ICSI）是一种常见的程序，用于提高生殖结果，即使在没有男性因素不孕的夫妇中也是如此。然而，关于该程序在没有正式 ICSI 适应证的患者中可能具有的优势和缺陷的现有证据仍然不确定。
SWOT（优势、劣势、机会、威胁）分析检查了在这些没有正式适应证的患者中进行 ICSI 的可能优势和缺陷。
证据表明，ICSI 对于需要体外受精的非男性因素不孕夫妇来说是不合理的。与该程序相关的主要优势之一是，虚拟消除了因完全受精失败而进一步复杂化的病例，并且文献中建议在同胞卵母细胞上结合 IVF 和 ICSI。该程序的一些弱点包括更大的技术难度、更高的成本和在某些情况下进行不必要的侵入性技术，并且不应排除对安全问题的质疑。
尽管 ICSI 在没有男性因素不孕正式诊断的患者中广泛使用，但在该人群中证明其有效性的证据仍然缺乏。需要进行更多大型和精心设计的随机对照试验，以明确非男性因素不孕中 ICSI 的明确适应证。
