Although use of an IVF treatment for male infertility, known as intracytoplasmic sperm injection, has doubled in the past decade, the procedure is not always associated with better outcomes, according to a new study from the US Centres for Disease Control and Prevention. During ICSI, a single sperm is injected directly into an egg. The procedure, which was introduced in 1992, made it possible for many infertile men to father children.
“In the pre-ICSI days, couples with severe male infertility would frequently have to resort to donor insemination, thus eliminating the possibility of the man to be the genetic parent,” explained one expert, Dr. Avner Hershlag, chief of the Centre for Human Reproduction at North Shore University Hospital in Manhasset, N.Y. “There are now millions of children and adults whose fathers had deficient sperm, and it is because of ICSI that they have been created,” said Hershlag, who was not involved in the new study.
However, the CDC study authors said that unlike conventional in-vitro fertilization, ICSI is much more expensive. In conducting the study, the team of researchers, led by the CDC’s Sheree Boulet, analyzed almost 1.4 million fresh IVF cycles reported to the US National Assisted Reproductive Technology Surveillance System between 1996 and 2012. Of these IVF cycles, 65 percent involved ICSI and about 36 per cent involved male infertility. Among fresh IVF cycles, ICSI use in the United States increased from 36 per cent in 1996 to 76 per cent in 2012, the researchers reported.
In cases involving men with male infertility, ICSI use jumped from about 76 percent in 1996 to more than 93 per cent by 2012. Among men who were not infertile, ICSI use rose from just over 15 per cent to about 67 per cent. Between 2008 and 2012, about 36 per cent of fresh IVF cycles involved male infertility. The researchers noted that when male infertility was not an issue, using ICSI in an IVF procedure was tied to a slight drop in implantation, pregnancy, live birth and low birth weight rates, compared to using conventional IVF.