It's more expensive, unnecessary and unhealthier: so why do IVF clinics prefer ICSI?

Michael Cook
16 Nov 2013
Reproduced with Permission

Despite complaints from experts, more and more IVF clinics are using intra-cytoplasmic sperm injection (ICSI). Lisa Jardine, the outgoing head of the Human Fertilisation and Embryology Authority (HFEA), complained earlier this month that some clinics are using ICSI only because it is easier rather than because it is in the best interests of patients.

"We believe it is being used far too widely because it is procedurally easy," The Independent reported. "The scientists who advocate it already know that a boy born through ICSI is likely to have a low sperm count. So it is a little bit worrying that it is being rolled out so widely." Studies have shown that ICSI leads to more health problems for the children. It is also more expensive.

Writing in BioNews, Steven Fleming, of the University of Sydney, says in exasperation that the incidence of male factor infertility is only 30 to 40%, but that ICSI is being used to treat 53 to 68% of infertile couples in Australia, New Zealand and the UK. Presumably doctors believe that ICSI will result in higher pregnancy rates, but there is no convincing evidence for this.

"We know that babies born from ICSI have increased risk of some problems later in life and infertility is one of them," Allan Pacey, chairman of the British Fertility Society, told The Independent. "For these reasons we should be prudent over the use of ICSI. So let's use ICSI when it's needed, and not as some kind of guarantee against fertilisation failure, which is how some clinics approach it."