Rescue Intracytoplasmic Sperm Injection: a Systematic Review

Objective: To assess the feasibility, efficacy, and safety of rescue intracytoplasmic sperm injection (ICSI) in cases of fertilization failure, using a scientific literature search.

Design: Systematic review.

Setting: Centers for reproductive care.

Patient(s): Infertility patients with total or partial fertilization failure during an IVF cycle.

Intervention(s): An electronic literature search was performed in PubMed from 1992 through May 2013. The search was then expanded by using listed references from selected articles.

Main Outcome Measure(s): Pregnancy rate. The secondary outcome measures were fertilization rate, normal fertilization rate, cleavage rate, birth rate, and malformation rate.

Result(s): Thirty-eight studies including 1,863 patients were included. The pooled pregnancy rate was 14.4%; 194 babies were delivered.

Conclusion(s): Rescue ICSI can result in the delivery of a healthy newborn, although the pregnancy rates are low. The clinical evidence did not indicate an elevated rate of malformations, although the data are limited and incomplete.