Does intracytoplasmic sperm injection improve the fertilization rate and decrease the total fertilization failure rate in couples with well-defined unexplained.

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Presentation transcript:

Does intracytoplasmic sperm injection improve the fertilization rate and decrease the total fertilization failure rate in couples with well-defined unexplained infertility? A systematic review and meta-analysis Lauren N.C. Johnson, M.D., Isaac E. Sasson, M.D., Ph.D., Mary D. Sammel, Sc.D., Anuja Dokras, M.D., Ph.D. Fertility and Sterility Volume 100, Issue 3, Pages 704-711 (September 2013) DOI: 10.1016/j.fertnstert.2013.04.038 Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Flow chart of the literature search. Fertility and Sterility 2013 100, 704-711DOI: (10.1016/j.fertnstert.2013.04.038) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Forest plots for fertilization rate per injected oocyte, fertilization rate per retrieved oocyte, and total fertilization failure. (A) Fertilization rate per injected oocyte for sibling oocytes split between intracytoplasmic sperm injection (ICSI) and conventional insemination. (B) Fertilization rate per retrieved oocyte for sibling oocytes split between ICSI and conventional insemination. (C) Total fertilization failure in sibling oocytes assigned to conventional insemination versus ICSI. CI = confidence interval; RR = relative risk. Fertility and Sterility 2013 100, 704-711DOI: (10.1016/j.fertnstert.2013.04.038) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Forest plots for fertilization rate per injected oocyte, fertilization rate per retrieved oocyte, and total fertilization failure. (A) Fertilization rate per injected oocyte for sibling oocytes split between intracytoplasmic sperm injection (ICSI) and conventional insemination. (B) Fertilization rate per retrieved oocyte for sibling oocytes split between ICSI and conventional insemination. (C) Total fertilization failure in sibling oocytes assigned to conventional insemination versus ICSI. CI = confidence interval; RR = relative risk. Fertility and Sterility 2013 100, 704-711DOI: (10.1016/j.fertnstert.2013.04.038) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Funnel plot showing relative risk of total fertilization failure with conventional insemination compared with intracytoplasmic sperm injection as an indicator of publication bias. Each point represents the relative risk of total fertilization failure from one of the 11 studies included in the analysis measured against the standard error of the log relative risk (RR). The vertical line represents the estimate of the effect, and the dashed lines represent the pseudo 95% confidence intervals. Fertility and Sterility 2013 100, 704-711DOI: (10.1016/j.fertnstert.2013.04.038) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions