{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T04:16:22Z","timestamp":1769314582276,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T00:00:00Z","timestamp":1485820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite questionable evidence of benefits over conventional in vitro fertilization (<jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content>), intracytoplasmic sperm injection (<jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content>) use has markedly increased in recent decades among couples without male factor infertility. We assessed the frequency of <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> use and its effect on birth outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted in 141 030 women conceiving through <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content> using 2006\u20132010 data from the Society for Assisted Reproductive Technology (<jats:styled-content style=\"fixed-case\">SART<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2006 and 2010, overall <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> use in women conceiving through <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content> increased from 68.9% to 73.1%. This increase was greater among women without male factor infertility (53.0\u201359.2%) than in women with male factor infertility (92.0\u201393.4%). Women conceiving through <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content> with and without <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> had similar rates of multiple pregnancy, preterm delivery, stillbirth, and neonatal death. However, <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> pregnancies were associated with an increased risk of birth defects over conventional <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content> (3.0% for <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> vs. 2.5% for conventional <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content>; adjusted odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 1.2, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 1.2, 1.3). These increases were observed in both women conceiving through <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> with male factor infertility (3.2% vs. 2.5%; <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.4, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.3, 1.5) and without male factor infertility (2.7% vs. 2.5%; <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.1, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.1, 1.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Higher rates of birth defects were observed among women conceiving through <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content>. Since approximately half of all <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> procedures are performed in couples without male factor infertility, <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content> may be overused in practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12339","type":"journal-article","created":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T16:52:12Z","timestamp":1485881532000},"page":"108-115","source":"Crossref","is-referenced-by-count":13,"title":["Use of Intracytoplasmic Sperm Injection and Birth Outcomes in Women Conceiving through In Vitro Fertilization"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9292-5059","authenticated-orcid":false,"given":"Xu","family":"Xiong","sequence":"first","affiliation":[{"name":"Department of Epidemiology School of Public Health and Tropical Medicine Tulane University New Orleans LA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard P.","family":"Dickey","sequence":"additional","affiliation":[{"name":"Section of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology Louisiana State University School of Medicine, and The Fertility Institute of New Orleans Mandeville LA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Buekens","sequence":"additional","affiliation":[{"name":"Department of Epidemiology School of Public Health and Tropical Medicine Tulane University New Orleans LA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey G.","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics School of Public Health and Tropical Medicine Tulane University New Orleans 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