title: Should few retrieved oocytes be as an indication for intracytoplasmic sperm injection?
abstract: OBJECTIVE
  To reevaluate whether relatively few oocytes obtained in one cycle are an indication for intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  A total of 406 cycles with three or fewer retrieved oocytes performed in 396 non-male infertile couples were retrospectively reviewed. Cycles were classified into three groups by different fertilization techniques: the in vitro fertilization (IVF) group, insemination with conventional IVF; the ICSI group, insemination with ICSI though semen parameters were normal; and the rescue ICSI group, re-insemination with ICSI after conventional IVF failure.
  
  
  RESULTS
  The ICSI group resulted in higher normal fertilization compared with the conventional IVF group. Correspondingly, the cycle cancellation rate was decreased in the ICSI group, though it was not statistically significant. The clinical pregnancy rate and implantation rate were lower in the ICSI group compared with the conventional IVF group. Rescue ICSI was a method to avert total fertilization failure in conventional IVF, increasing fertilization and ensuring embryo availability for transfer, but the normal fertilization was the lowest due to delayed insemination and the chance of pregnancy was very little.
  
  
  CONCLUSIONS
  Obtaining only few oocytes in one cycle is not considered as an indication for ICSI when the sperm sample is apparently normal. Rescue ICSI is either not recommended if conventional insemination fails. Such patients should not be subjected to the unnecessary costs and potential risks of ICSI.
authors.affiliation: Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
authors.forename: Qing-song
authors.initials: QS
authors.lastname: Xi
authors.forename: Li-xia
authors.initials: LX
authors.lastname: Zhu
authors.forename: Juan
authors.initials: J
authors.lastname: Hu
authors.forename: Li
authors.initials: L
authors.lastname: Wu
authors.forename: Han-wang
authors.initials: HW
authors.lastname: Zhang
mesh_terms: D000328:Adult; D002681:China; D015331:Cohort Studies; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D054315:Oocyte Retrieval; D009865:Oocytes; D011247:Pregnancy; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data