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However, several studies analyzing the broad use of intracytoplasmic sperm injection, even in cases with a normal semen analysis, have collectively demonstrated no benefits compared to conventional in\u2010vitro fertilization. Currently, there is insufficient evidence to support the intracytoplasmic sperm injection technique vs. in\u2010vitro fertilization in cases of poor ovarian response or a low number of oocytes collected, or in patients with advanced maternal age. Since the intracytoplasmic sperm injection technique is more operator\u2010dependent and invasive, its use should only be recommended in cases of male\u2010factor infertility. There is some evidence showing that intracytoplasmic sperm injection is linked with an increased risk of birth defects. Albeit this evidence is limited, and currently it is not possible to draw a firm conclusion on these concerns, we do believe that these risks should be rigorously investigated. Thus, this review aims to clarify the debate on the application of the intracytoplasmic sperm injection procedure, as compared to standard in\u2010vitro fertilization, in those assisted reproductive technology cycles without a clear male factor infertility. Furthermore, we try to clarify whether intracytoplasmic sperm injection would result in a higher live birth rate than in\u2010vitro fertilization, in couples with non\u2010male factor infertility.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13468","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T10:38:40Z","timestamp":1685615920000},"page":"20-29","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Intracytoplasmic sperm injection vs. in\u2010vitro fertilization in couples in whom the male partners had a semen analysis within normal reference ranges: An open debate"],"prefix":"10.1111","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7698-8823","authenticated-orcid":false,"given":"Romualdo","family":"Sciorio","sequence":"first","affiliation":[{"name":"Edinburgh Assisted Conception Programme, EFREC Royal Infirmary of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Discipline of Anatomy &amp; Histology School of Medical Sciences University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deaa250"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deaa090"},{"key":"e_1_2_8_4_1","volume-title":"Assisted Reproductive Technology in Australia and New Zealand 2005","author":"Wang YA","year":"2007"},{"key":"e_1_2_8_5_1","volume-title":"Assisted Reproductive Technology in Australia and New Zealand 2014","author":"Harris K","year":"2016"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.17985"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmn032"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.08.026"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","unstructured":"ESHRE. 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