Microassisted fertilization in assisted conception: indications and patient impact.

Microassisted fertilization is fast becoming established as a routine clinical technique offering the chance of pregnancy to couples where none existed previously. The exceptional results of SUZI and, more particularly, ICSI now raise the prospect of pregnancy with any sperm in the ejaculate and are bringing to treatment focus some azoospermic men and men without an antegrade ejaculate. The advance in clinical results from SUZI and ICSI over earlier zona drilling and zona breaching techniques appear to be importantly related to the better implantation potential of the embryos. The implications for the way conventional IVF is performed still need to be digested but may be very important and may change our attitude to ovarian stimulation and insemination regimens.