IVF clinics may be overusing the fertility treatment known as ICSI, or intracytoplasmic sperm injection, according to a new study published in the New England Journal of Medicine. ICSI is a fertility treatment used to treat low semen count or poor sperm quality, two types of male infertility. To perform ICSI, laboratory specialists place a single sperm into an egg using a tiny syringe. ICSI is used as an add on to IVF, or in vitro fertilization.
The percentage of IVF cycles that used ICSI increased from 11 percent in 1995 to 57.5 percent in 2004, despite the fact that only 34 percent of couples seeking treatment had issues with low sperm count or poor sperm quality, according to Head researcher Tarun Jain, assistant professor of reproductive endocrinology and infertility at the University of Illinois-Chicago, and colleagues.
In a separate statement, Dr. Jain pointed out that “despite its added cost and uncertain efficacy and risk, the use of ICSI has been extended to include patients without documented male-factor infertility.”
Dr. Arthur Caplan, director of the Center for Bioethics at University of Pennsylvania’s, reacted to the research results: “This paper is particularly troubling because we’ve got a major shift in practice that isn’t evidence driven. The paper suggests it may be driven by money”
Success rates for ICSI with IVF
About 31% of IVF cycles using ICSI resulted in live births, compared with 33% for those that did not use ICSI.
Cost of IVF with ICSI
The average cost of IVF treatment in the U.S. is $12,400. Adding ICSI to IVF adds an average $1,500 to the net cost for fertility patients.