Miller D, et al. - In this parallel, two-group, randomized trial, authors assessed females (aged 18–43 years) with a body mass index of 19–35 kg/m² to examine the effectiveness of physiological intracytoplasmic sperm injection (ICSI)[PICSI] vs standard ICSI for improving live birth rates among couples undergoing fertility treatment. They observed no significant difference in term livebirth rate between PICSI (27·4% [379/1381]) and ICSI (25·2% [346/1371]) groups. About 56 serious adverse events in total, including 31 in the PICSI group and 25 in the ICSI group (most were congenital abnormalities) were also noted. They suggested that wider use of PICSI should be avoided.