Should ICSI be recommended routinely in patients with four or fewer oocytes retrieved?

Martha Luna, Catherine Bigelow, Marlena Duke, Jane Ruman, Benjamin Sandler, Lawrence Grunfeld, Alan B. Copperman

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Purpose: 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. Result(s): 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. Conclusion(s): Our results demonstrate that in the presence of normal semen parameters, low egg number is not an indication to perform ICSI.

Original languageEnglish
Pages (from-to)911-915
Number of pages5
JournalJournal of Assisted Reproduction and Genetics
Issue number10
StatePublished - Sep 2011


  • ICSI
  • IVF
  • Oocyte retrieval
  • Poor response


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