Published online by Cambridge University Press: 02 December 2021
ICSI is a well-established insemination method in IVF due to its overall efficacy and reliability, even when severe male factor is not the main cause of infertility. Although conventional-ICSI provides high fertilization rate, it suffers from some technical drawbacks. Sudden or delayed oocyte degeneration may occur after ICSI even when performed by experienced embryologist and extreme care is applied during the injection phase. Preliminary results from studies conducted in early 2000s suggest that laser-assisted micro-drilling of the zona pellucida before injection (LA-ICSI) may be useful to make ICSI more successful when inseminating oocytes more prone to fertilization failure. Although this condition does not affect many couples, in case of degeneration of all the injected oocytes the IVF cycle must be cancelled. In these cases, LA-ICSI becomes a valuable option that deserves consideration.