Bioethics News

IVF expert complains about unjustifiable use of ICSI around the world

The editor-in-chief of one of the world’s leading reproductive medicine journals has attacked the rising use of intracytoplasmic sperm injection (ICSI) for the treatment of infertility, following publication of the latest world report on assisted reproductive technologies (ART).

The report in Human Reproduction shows that while ICSI use has levelled off in some regions, its use is approaching 100% of assisted reproduction cycles in the Middle East and a few countries in other regions, despite the fact that ICSI was developed for the treatment of male infertility, which is a factor in around 40% of couples seeking fertility treatment. The world report covers the years 2008, 2009 and 2010 — the years for which the most recent data are available.

In a savage editorial entitled “Santa Claus in the fertility clinic”, to accompany the world report, Professor Hans Evers highlights the fact that in 2010 there were 220,000 in vitro fertilisation (IVF) treatments, but there were more than 455,000 ICSI treatments in the world. There was 1.4 times as much ICSI than IVF in Asia, twice as much in sub-Saharan Africa, just over twice as much in Europe, 2.7 times as much in North America, more than 6 times as much in Latin America and more than 60 times as much in the Middle East. (Statistics for the ICSI:IVF ratio for Australian and New Zealand were not available.)

He writes that doctors are guilty of over-estimating the effect of ICSI. “The majority of the patients who will get pregnant with intracytoplasmic sperm injection (ICSI) will also do so with IVF.”

Studies have shown that ICSI results in fewer live births than IVF when used for couples where male infertility is not the problem.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.