To determine whether intracytoplasmic sperm injection (ICSI) improves cumulative live birth rates (cLBR) compared with conventional IVF among patients with non-male factor infertility.
This descriptive retrospective cohort study used linked Canadian Assisted Reproductive Technologies Registry (CARTR Plus) and Better Outcomes Registry & Network (BORN) data from 2013 to 2022. Outcomes were compared by insemination technique (IVF vs. ICSI). The primary outcome was cLBR per retrieval; secondary outcomes included normal fertilization (2PN), fertilization rate, utilizable embryos per retrieval, and cycles without live birth.
Among 140,252 retrieval cycles (35,251 IVF; 105,001 ICSI), cLBR was higher with conventional IVF (38.5% vs. 36.3%, p < 0.001). Oocyte yield was similar, although more oocytes were inseminated with IVF. Fertilization rates were slightly higher with ICSI, but normal fertilization and utilizable embryos per retrieval were comparable.
In non-male factor infertility, ICSI does not improve cumulative live birth outcomes compared with conventional IVF.
Frontiers in reproductive health. 2026 Apr 29*** epublish ***
Z M Ferraro, L Meng, K E Liu, E M Greenblatt, M A Russo
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada., Better Outcomes Registry & Network (BORN), Centre for Practice-Changing Research Building, Ottawa, Ontario, Canada.