An effective, simplified, and practical approach to intracytoplasmic sperm injection at multiple IVF centers.

Purpose: Our purpose was to use effectively a simplified approach for intracytoplasmic sperm injection (ICSI) that achieves high levels of fertilization, embryo cleavage, and subsequent establishment of clinical pregnancies.

Methods: In a multicenter clinical analysis, 1814 mature oocytes were injected with a single sperm using a finely beveled (30 degrees) pipette without a spiked tip that was backfilled with an inert, silicone polymer. The injection system was composed of a sterile water-filled tubing interconnecting the pipette and a 20-gauge needle attached to a three-way stopcock and 5-ml disposable syringe. The efficiency of the ICSI procedure was assessed by analyzing fertilization, lysis, and cleavage rates, as well as pregnancy outcomes.

Results: High levels of normal fertilization (2PN; 56.4-73.5% of all eggs injected) and reasonably low lysis rates (9-16%) were produced. The efficiency of embryo formation was high (87-93%), with only 6 of 177 (3.4%) patients failing to produce an embryo. Clinical pregnancies were established by each IVF center (18-34% ongoing pregnancy/birth rate).

Conclusions: Effective ICSI was achieved using a novel, simplified technique involving sharply beveled pipettes (without additional tip modification), simple sperm washing/handling procedures, and a disposable syringe injection system that offered extremely fine control for sperm manipulation.