Successful intracytoplasmic sperm injection without performing cytoplasmic aspiration.

Objective: To compare the effect of cytoplasmic aspiration versus no aspiration before intracytoplasmic sperm injection (ICSI) on the rate of oocyte damage, fertilization rate, and embryo quality.

Design: A randomized prospective study on sibling oocytes.

Setting: The Egyptian IVF-ET Center, Cairo, Egypt.

Participants: Fifty-eight patients who were infertile due to male factor who underwent 60 ICSI cycles.

Intervention: Intracytoplasmic sperm injection was performed on randomly allocated metaphase II oocytes with cytoplasmic aspiration in group I and without cytoplasmic aspiration in group II before sperm injection.

Main Outcome Measure: Fertilization rate, oocyte damage rate, and embryo quality.

Results: Normal fertilization rate per injected oocyte was 61.4% in group I compared with 62.5% in group II. The damage rate per injected oocyte was 16.8% in group I compared with 4.6% in group II. Grade I embryos were 24.5% in group I compared with 48.5% in group II.

Conclusion: Cytoplasmic aspiration before sperm injection in ICSI is not essential for oocyte activation. It did not improve the rate of normal fertilization. On the other hand, it increased the damaged oocyte rate and the rate of cytoplasmic fragments.