{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:42:44Z","timestamp":1790368964343,"version":"4.1.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T00:00:00Z","timestamp":1666915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study is to determine whether intracytoplasmic sperm injection (ICSI) is beneficial in patients with non-male factor infertility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This systematic review and meta-analysis included articles from inception to May 2022. Published studies of non-male factor infertile women undergoing ICSI or <jats:italic>in vitro<\/jats:italic> fertilization (IVF) included in PubMed, Embase, web of science, Wanfang Database, and CNKI were searched by computer, without language restrictions. A random-effect model was applied to calculate the risk ratios (RRs) and their 95% confidence intervals (CIs). Letters, case reports, and review articles including meta-analyses and expert opinions were excluded. The primary endpoints were laboratory outcomes and pregnancy outcomes. The Secondary endpoints were neonatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six randomized controlled studies and 20 retrospective cohort studies met the inclusion criteria. In meta-analytic forest plots, compared with IVF, those who received ICSI treatment were not different in fertilization rate (RR\u2009=\u20090.99, 95% CI [0.90\u20131.09], <jats:italic>P<\/jats:italic>\u2009=\u20090.88), total fertilization failure rate (RR\u2009=\u20091.30, 95% CI [1.17\u20131.45], <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.00001), and good quality embryo rate (RR\u2009=\u20090.94, 95% CI [ 0.86\u20131.02], <jats:italic>P<\/jats:italic>\u2009=\u20090.15), clinical pregnancy rate (RR\u2009=\u20090.84, 95% CI [0.70\u20131.01], <jats:italic>P<\/jats:italic>\u2009=\u20090.06), live birth rate (RR\u2009=\u20090.89, 95% CI [0.77\u20131.03], <jats:italic>P<\/jats:italic>\u2009=\u20090.13), miscarriage rate (RR\u2009=\u20091.06, 95% CI [0.78\u20131.43], <jats:italic>P<\/jats:italic>\u2009=\u20090.71), preterm neonatal delivery rate (RR\u2009=\u20090.92, 95% CI [0.67\u20131.26], <jats:italic>P<\/jats:italic>\u2009=\u20090.61), and low neonatal weight rate (RR\u2009=\u20091.13, 95% CI [0.80\u20131.61], <jats:italic>P<\/jats:italic>\u2009=\u20090.48). However, the implantation rate of IVF was better than ICSI (RR\u2009=\u20090.77, 95% CI [0.64\u20130.93], <jats:italic>P<\/jats:italic>\u2009=\u20090.005). In the subgroup analysis of the live birth rate of fresh embryo transfer, IVF performed in those \u226535 years had a higher live birth rate (RR\u2009=\u20090.82, 95% CI [0.78\u20130.83], <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The findings of this study indicate that ICSI is not superior to IVF in the treatment of infertility related to non-male factors. In order to confirm this result, more high-quality clinical studies are needed.<\/jats:p><\/jats:sec>","DOI":"10.3389\/frph.2022.1029381","type":"journal-article","created":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T09:30:30Z","timestamp":1666949430000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Impact of intracytoplasmic sperm injection in women with non-male factor infertility: A systematic review and meta-analysis"],"prefix":"10.3389","volume":"4","author":[{"given":"Jun-Xia","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Qi","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Tong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Qi","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Yan","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-Gao","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1001\/jama.2014.17985","article-title":"Trends in use of and reproductive outcomes associated with intracytoplasmic sperm injection","volume":"313","author":"Boulet","year":"2015","journal-title":"J Am Med Assoc"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1093\/humrep\/dey242","article-title":"ART in Europe, 2014: results generated from European registries by ESHRE: the European IVF-monitoring consortium (EIM) for the European society of human reproduction and embryology (ESHRE)","volume":"33","author":"De Geyter","year":"2018","journal-title":"Hum Reprod"},{"key":"B3","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/BF02861869","article-title":"Fertilization of IVF\/ICSI using sibling oocytes from couples with subfertile male or unexplained infertility","volume":"24","author":"Li","year":"2004","journal-title":"J Huazhong Univ Sci Technolog Med Sci"},{"key":"B4","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1016\/j.jgyn.2012.06.004","article-title":"Comparison of IVF outcomes using conventional insemination and ICSI in ovarian cycles in which only one or two oocytes are obtained","volume":"41","author":"Fang","year":"2012","journal-title":"J Gynecol Obstet Biol Reprod"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.19460\/j.cnki.0253-3685.2012.12.026","article-title":"Effect of fertilization mode on assisted conception outcome in low ovarian response cycles","volume":"38","author":"Cao","year":"2012","journal-title":"Jiangsu Pharmaceutical"},{"key":"B6","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/S0015-0282(00)01674-5","article-title":"Intracytoplasmic sperm injection increased fertilization and good-quality embryo formation in patients with non-male factor indications for in vitro fertilization: a prospective randomized study","volume":"75","author":"Khamsi","year":"2001","journal-title":"Fertil Steril"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8101694","article-title":"ICSI versus conventional IVF in women aged 40 years or more and unexplained infertility: a retrospective evaluation of 685 cycles with propensity score model","volume":"8","author":"Gennarelli","year":"2019","journal-title":"J Clin Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.1007\/s10815-022-02404-4","article-title":"Placental histology and pregnancy complications following intracytoplasmic sperm injection for non-male factor infertility","volume":"39","author":"Ganer Herman","year":"2022","journal-title":"J Assist Reprod Genet"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1981","DOI":"10.11675\/j.issn.0253-4304.2020.15.18","article-title":"Comparison of two insemination methods for in vitro fertilization-embryo transfer in high-risk patients with low-acquired eggs","volume":"42","author":"Huang","year":"2020","journal-title":"Guangxi Medical"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1007\/s00404-018-4696-6","article-title":"Conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI): which is preferred for advanced age patients with five or fewer oocytes retrieved?","volume":"297","author":"Liu","year":"2018","journal-title":"Arch Gynecol Obstet"},{"key":"B11","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1007\/s10815-015-0459-5","article-title":"Live birth rates using conventional in vitro fertilization compared to intracytoplasmic sperm injection in Bologna poor responders with a single oocyte retrieved","volume":"32","author":"Sfontouris","year":"2015","journal-title":"J Assist Reprod Genet"},{"key":"B12","doi-asserted-by":"publisher","first-page":"hox013","DOI":"10.1093\/hropen\/hox013","article-title":"Is there a reason to perform ICSI in the absence of male factor? Lessons from the latin American registry of ART","volume":"2017","author":"Schwarze","year":"2017","journal-title":"Hum Reprod Open"},{"key":"B13","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.ejogrb.2014.03.044","article-title":"Can intracytoplasmic sperm injection prevent total fertilization failure and enhance embryo quality in patients with non-male factor infertility?","volume":"178","author":"Kim","year":"2014","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s10815-012-9922-8","article-title":"Conventional IVF versus ICSI in sibling oocytes from couples with endometriosis and normozoospermic semen","volume":"30","author":"Komsky-Elbaz","year":"2013","journal-title":"J Assist Reprod Genet"},{"key":"B15","first-page":"21593","article-title":"Conventional in vitro fertilization maybe yields more available embryos than intracytoplasmic sperm injection for patients with no indications for ICSI","volume":"8","author":"Ming","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"B16","first-page":"80","article-title":"Effectiveness of different fertilization modalities in treating high-risk female patients with non-male factor infertility","volume":"18","author":"Liu","year":"2021","journal-title":"China Medical Herald"},{"key":"B17","doi-asserted-by":"publisher","first-page":"101990","DOI":"10.1016\/j.jogoh.2020.101990","article-title":"Conventional IVF revisited: is ICSI better for non-Male factor infertility? Randomized controlled double blind study","volume":"50","author":"Isikoglu","year":"2021","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"B18","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1093\/humrep\/dez301","article-title":"ICSI does not improve reproductive outcomes in autologous ovarian response cycles with non-male factor subfertility","volume":"35","author":"Supramaniam","year":"2020","journal-title":"Hum Reprod"},{"key":"B19","doi-asserted-by":"publisher","first-page":"2077","DOI":"10.1007\/s10815-019-01586-8","article-title":"Correction to: ICSI does not offer any benefit over conventional IVF across different ovarian response categories in non-male factor infertility: a European multicenter analysis","volume":"36","author":"Drakopoulos","year":"2019","journal-title":"J Assist Reprod Genet"},{"key":"B20","doi-asserted-by":"publisher","first-page":"997","DOI":"10.3109\/09513590.2013.822063","article-title":"Conventional IVF as a laboratory strategy to rescue fertility potential in severe poor responder patients: the impact of reproductive aging","volume":"29","author":"Artini","year":"2013","journal-title":"Gynecol Endocrinol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1631\/jzus.B1100370","article-title":"Should few retrieved oocytes be as an indication for intracytoplasmic sperm injection?","volume":"13","author":"Xi","year":"2012","journal-title":"J Zhejiang Univ Sci B"},{"key":"B22","doi-asserted-by":"publisher","first-page":"210","DOI":"10.4103\/jhrs.JHRS_8_19","article-title":"Are we justified doing routine intracytoplasmic sperm injection in nonmale factor infertility? A retrospective study comparing reproductive outcomes between in vitro fertilization and intracytoplasmic sperm injection in nonmale factor infertility","volume":"12","author":"Biliangady","year":"2019","journal-title":"J Hum Reprod Sci"},{"key":"B23","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1093\/humrep\/dew298","article-title":"The role of intracytoplasmic sperm injection in non-male factor infertility in advanced maternal age","volume":"32","author":"Tannus","year":"2017","journal-title":"Hum Reprod"},{"key":"B24","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/s12958-021-00804-2","article-title":"More blastocysts are produced from fewer oocytes in ICSI compared to IVF - results from a sibling oocytes study and definition of a new key performance indicator","volume":"19","author":"Chamayou","year":"2021","journal-title":"Reprod Biol Endocrinol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"2075","DOI":"10.1016\/S0140-6736(00)05179-5","article-title":"Conventional in-vitro fertilisation versus intracytoplasmic sperm injection for the treatment of non-male-factor infertility: a randomised controlled trial","volume":"357","author":"Bhattacharya","year":"2001","journal-title":"Lancet"},{"key":"B26","first-page":"251","article-title":"Comparison of the effects of IVF and ICSI in non-male factor infertility with ultra-ovulatory low-fertility cycles","volume":"32","author":"Hongchuan","year":"2012","journal-title":"J South Med Univ"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1016\/S0140-6736(21)00535-3","article-title":"Intracytoplasmic sperm injection versus conventional in-vitro fertilisation in couples with infertility in whom the male partner has normal total sperm count and motility: an open-label, randomised controlled trial","volume":"397","author":"Dang","year":"2021","journal-title":"Lancet"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1322","DOI":"10.1093\/humrep\/dey118","article-title":"ICSI does not increase the cumulative live birth rate in non-male factor infertility","volume":"33","author":"Li","year":"2018","journal-title":"Hum Reprod"},{"key":"B29","doi-asserted-by":"publisher","first-page":"458","DOI":"10.3969\/.jissn.1004-3845.2020.04.006","article-title":"Effect of ICSI on fertility outcomes in high-risk non-male factor infertility patients","volume":"29","author":"Jiahong","year":"2020","journal-title":"J Reprod Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"2067","DOI":"10.1007\/s10815-019-01563-1","article-title":"ICSI does not offer any benefit over conventional IVF across different ovarian response categories in non-male factor infertility: a European multicenter analysis","volume":"36","author":"Drakopoulos","year":"2019","journal-title":"J Assist Reprod Genet"},{"key":"B31","doi-asserted-by":"publisher","first-page":"F61","DOI":"10.1530\/REP-17-0344","article-title":"The safety of intracytoplasmic sperm injection and long-term outcomes","volume":"154","author":"Pereira","year":"2017","journal-title":"Reproduction"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1093\/humrep\/15.6.1278","article-title":"Should ICSI be the treatment of choice for all cases of in-vitro conception?","volume":"15","author":"Fishel","year":"2000","journal-title":"Hum Reprod"},{"key":"B33","first-page":"203","article-title":"Effect of method of oocyte fertilization on fertilization, pregnancy and implantation rates in women with unexplained infertility","volume":"38","author":"Check","year":"2011","journal-title":"Clin Exp Obstet Gynecol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1007\/s10815-011-9614-9","article-title":"Should ICSI be recommended routinely in patients with four or fewer oocytes retrieved?","volume":"28","author":"Luna","year":"2011","journal-title":"J Assist Reprod Genet"},{"key":"B35","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3969\/jissn1674-4020.2010.01.002","article-title":"Observation of the effect of fertilization on embryo quality at different periods after in vitro fertilization. Family planning and obstetrics and gynaecology","volume":"2","author":"Weifen","year":"2010","journal-title":"China"},{"key":"B36","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1007\/978-1-4939-0659-8_26","article-title":"Safety of intracytoplasmic sperm injection","volume":"1154","author":"Palermo","year":"2014","journal-title":"Methods Mol Biol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1002\/uog.18932","article-title":"Congenital heart defects in IVF\/ICSI pregnancy: systematic review and meta-analysis","volume":"51","author":"Giorgione","year":"2018","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1093\/humrep\/deaa002","article-title":"Intracytoplasmic sperm injection is not superior to conventional IVF in couples with non-male factor infertility and preimplantation genetic testing for aneuploidies (PGT-A)","volume":"35","author":"De Munck","year":"2020","journal-title":"Hum Reprod"},{"key":"B39","doi-asserted-by":"publisher","first-page":"5722","DOI":"10.3390\/jcm11195722","article-title":"Opportunities and limits of conventional IVF versus ICSI: it is time to come off the fence","volume":"11","author":"Balli","year":"2022","journal-title":"J Clin Med"},{"key":"B40","doi-asserted-by":"publisher","first-page":"777","DOI":"10.36740\/WLek202103240","article-title":"An overview of autoimmunity in implantation failure: a literature review","volume":"74","author":"Berestoviy","year":"2021","journal-title":"Wiad Lek"},{"key":"B41","doi-asserted-by":"publisher","first-page":"473","DOI":"10.4103\/aja.aja_124_18","article-title":"Success rates of in vitro fertilization versus intracytoplasmic sperm injection in men with serum anti-sperm antibodies: a consecutive cohort study","volume":"21","author":"Lu","year":"2019","journal-title":"Asian J Androl"},{"key":"B42","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1007\/s10815-020-01990-5","article-title":"The role of ICSI vs. conventional IVF for patients with advanced maternal age-a randomized controlled trial","volume":"38","author":"Haas","year":"2021","journal-title":"J Assist Reprod Genet"},{"key":"B43","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.fertnstert.2019.09.035","article-title":"Comparing fertilization rates from intracytoplasmic sperm injection to conventional in vitro fertilization among women of advanced age with non-male factor infertility: a meta-analysis","volume":"113","author":"Sunderam","year":"2020","journal-title":"Fertil Steril"},{"key":"B44","doi-asserted-by":"publisher","first-page":"2929","DOI":"10.1007\/s10815-020-01970-9","article-title":"The effect of ICSI in infertility couples with non-male factor: a systematic review and meta-analysis","volume":"37","author":"Geng","year":"2020","journal-title":"J Assist Reprod Genet"},{"key":"B45","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1111\/ajo.13004","article-title":"Use of intracytoplasmic sperm injection (ICSI) in normospermic men may result in lower clinical pregnancy and live birth rates","volume":"59","author":"Sustar","year":"2019","journal-title":"Aust N Z J Obstet Gynaecol"}],"container-title":["Frontiers in Reproductive Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2022.1029381\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T09:30:42Z","timestamp":1666949442000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2022.1029381\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,28]]},"references-count":45,"alternative-id":["10.3389\/frph.2022.1029381"],"URL":"https:\/\/doi.org\/10.3389\/frph.2022.1029381","relation":{},"ISSN":["2673-3153"],"issn-type":[{"value":"2673-3153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,28]]},"article-number":"1029381"}}