Introduction
For decades, Intracytoplasmic Sperm Injection (ICSI) has been the gold standard for treating severe male factor infertility. Since its clinical introduction in the early 1990s, ICSI has revolutionized the management of oligospermia and azoospermia. However, recent years have seen a significant trend toward the routine use of ICSI for all patients, regardless of sperm parameters—a practice often driven by the desire to minimize the risk of total fertilization failure. Despite its widespread adoption, evidence supporting the superiority of ICSI over conventional IVF (c-IVF) in cases without severe male factor infertility remains scarce. A secondary analysis of the INVICSI trial now provides critical insights into how these two fertilization methods affect early embryo development, morphokinetics, and overall embryo quality.