Table 4.

Characteristics of studies assessing the results of IMSI after several ICSI failures

Authors	Study design	Study population	Number of previous ICSI failures	Implantation rate (%)	Clinical pregnancy rate (%)	Miscarriage rate (%)	Live birth rate (%)
Bartoov et al. [13]	Retrospective study	62 couples with altered semen analysis, at least two ICSI failures: comparison with 50 couples paired according to number of previous ICSI failures	4.1	IMSI 27.9 ICSI 9.5 P < 0.01	IMSI 66 ICSI 30 P < 0.01	IMSI 9 ICSI 30 P < 0.01	IMSI 60 ICSI 20 P < 0.01
Berkovitz et al. [23]	Retrospective study	80 couples with at least 2 ICSI failures	3.9	IMSI 31.3 ICSI 9.4 P < 0.05	IMSI 60 ICSI 25 P < 0.05	IMSI 14 ICSI 40 P < 0.05	–
Antinori et al. [14] (subgroup C)	RCT	OAT 139 couples (62 ICSI, 77 IMSI)	≥2 (in subgroup C)	_	IMSI 29.9 ICSI 12.9 P < 0.05	IMSI 17.4 ICSI 37.5 NS	–
Knez et al. 2011 [24]	RCT	57 couples (37 ICSI, 20 IMSI) male infertility with altered sperm parameters and arrested embryos after prolonged 5-day embryo culture in previous ICSI cycles	Not specified	IMSI 17.1 ICSI 6.8 NS (low number of couples)	IMSI 25 ICSI 8 NS	–	–
El Khattabi et al. [25]	Prospective non- randomized observational study	220 couples (90 IMSI, 130 ICSI)	2 or more previous ICSI failures	IMSI 16.7 ICSI 16.1 NS	IMSI 24 ICSI 26 NS		IMSI 21 ICSI 22 NS
Klement et al. 2013 [26]	Prospective non-randomized observational study	449 couples male infertility factor (127 IMSI, 322 ICSI)	One ICSI failure		IMSI 56 ICSI 38 P = 0.002		IMSI 28 ICSI 18 P = 0.04

OAT oligoasthenoteratozoospermia