title: Should ICSI be recommended routinely in patients with four or fewer oocytes retrieved?
abstract: OBJECTIVE
  To determine if patients with a low response to controlled ovarian hyperstimulation during IVF benefit from intracytoplasmic sperm injection (ICSI)                                               METHODS:                          Retrospective analysis of 350 IVF cycles in which four or fewer oocytes were retrieved. Severe male factor cases were excluded from analysis. Conventional insemination (CI) and ICSI were compared, with primary outcome measures of fertilization rate, implantation rate, clinical pregnancy rate per embryo transfer, and pregnancy loss rate.
  
  
  RESULTS
  Fertilization rates per oocyte retrieved for CI and ICSI were comparable (51.5% vs. 51.8%). Parallel implantation rates (22% vs. 25%), clinical pregnancy rates (32.8% vs. 33.3%), and loss rates (26.7% vs. 39.5%) were also noted. No difference in cancelled cycles was reported.
  
  
  CONCLUSIONS
  Our results demonstrate that in the presence of normal semen parameters, low egg number is not an indication to perform ICSI.
authors.affiliation: Reproductive Medicine Associates of New York, New York, NY, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Luna
authors.forename: Catherine
authors.initials: C
authors.lastname: Bigelow
authors.forename: Marlena
authors.initials: M
authors.lastname: Duke
authors.forename: Jane
authors.initials: J
authors.lastname: Ruman
authors.forename: Benjamin
authors.initials: B
authors.lastname: Sandler
authors.forename: Lawrence
authors.initials: L
authors.lastname: Grunfeld
authors.forename: Alan B
authors.initials: AB
authors.lastname: Copperman
mesh_terms: D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D054315:Oocyte Retrieval; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic