Is intracytoplasmic sperm injection safe?

Objective: To review the pregnancy and birth outcomes of patients undergoing intracytoplasmic sperm injection (ICSI). Design: Selective review of the literature. Setting: Couples undergoing either conventional IVF or ICSI and their resulting offspring. Patient(s): None. Main Outcome Measure(s):None. Intervention(s): None. Result(s): These observational studies are unfortunately inherently biased. Regardless, the information and experiences from these large centers cannot be ignored. These experiences reveal that birth weight may be decreased by an amount that is generally not clinically relevant. Chromosomal and genetic abnormalities are increased probably only as a direct corollary to the underlying parental risk. Congenital malformations reveal no clustering of any single specific abnormality. Developmental assessment is available for up to 2 years, and no major delays have been identified in either motor or mental function. Conclusion(s): Intracytoplasmic sperm injection appears to be a safe alternative for couples who otherwise would be unable to achieve pregnancy. The inherent risks associated with these genetically "at risk" couples mandate thorough evaluation and counseling before undertaking ICSI. (C)2003 by American Society for Reproductive Medicine.