{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T00:06:12Z","timestamp":1777075572826,"version":"3.51.4"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T00:00:00Z","timestamp":1567123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Intracytoplasmic morphologically selected sperm injection (<jats:styled-content style=\"fixed-case\">IMSI<\/jats:styled-content>) is one of the sperm selection techniques used for assisted reproduction which has been applied for a variety of indications including previously failed fertilization with intracytoplasmic sperm injection (<jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content>). A Cochrane review<jats:sup>1<\/jats:sup> found no difference in outcomes between either modality of sperm selection. Since the Cochrane review was published there have been a further two randomized controlled trials comparing <jats:styled-content style=\"fixed-case\">IMSI<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content>. This systematic review and meta\u2010analysis aims to compare <jats:styled-content style=\"fixed-case\">IMSI<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> as insemination methods regarding live birth rate and miscarriage rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Systematic review of randomized controlled trials, observational studies and similar reviews in electronic databases published before January 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found nine randomized controlled trials, evaluating 1610 cycles of in vitro fertilization and 15 observational studies evaluating 1243 cycles of in vitro fertilization. Meta\u2010analysis of the included randomized controlled trials showed no difference in the live birth rate or miscarriage rate between the <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">IMSI<\/jats:styled-content> groups. Meta\u2010analysis of five observational studies showed a significantly higher number of live births in the <jats:styled-content style=\"fixed-case\">IMSI<\/jats:styled-content> group than <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> group (live birth rate <jats:styled-content style=\"fixed-case\">odds ratio<\/jats:styled-content> 1.47, 95% <jats:styled-content style=\"fixed-case\">confidence interval<\/jats:styled-content> 1.16\u20104.07), with a moderate degree of heterogeneity (I<jats:sup>2<\/jats:sup>\u00a0=\u00a041%). Additionally, from six observational studies, a significantly lower miscarriage rate was observed in the <jats:styled-content style=\"fixed-case\">IMSI<\/jats:styled-content> group than in the <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> group (<jats:styled-content style=\"fixed-case\">odds ratio<\/jats:styled-content> 0.51, 95% <jats:styled-content style=\"fixed-case\">confidence interval<\/jats:styled-content> 0.37\u20100.70, I<jats:sup>2<\/jats:sup>\u00a0=\u00a00%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Meta\u2010analysis of randomized studies comparing <jats:styled-content style=\"fixed-case\">IMSI<\/jats:styled-content> to <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> has not shown any difference in live birth rate and miscarriage rate. Meta\u2010analysis of observational studies, which must be interpreted with caution, revealed an increased live birth rate and decreased miscarriage rate with <jats:styled-content style=\"fixed-case\">IMSI<\/jats:styled-content> vs <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13703","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T14:47:51Z","timestamp":1565621271000},"page":"24-33","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Live birth and miscarriage rate following intracytoplasmic morphologically selected sperm injection vs intracytoplasmic sperm injection: An updated systematic review and 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