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    ICSI Male Infertility Treatment Up

    Dramatic 5-Fold Increase Coupled With IVF During Last Decade

    IVF, ICSI, and Male Infertility continued...

    While use of IVF roughly doubled over the decade -- from 45,900 fresh-embryo cycles in 1995 to 89,500 in 2004 -- more than five times as many ICSI procedures were being done in the last year of the observation period than in the first.

    The researchers found increasing use of ICSI relative to the percentage of couples with a diagnosis of male infertility in both states with and without mandated insurance coverage for infertility.

    They also found an increase in the overall number of infertility clinics and the number of pregnancies and live births achieved in patients undergoing assisted reproduction.

    ICSI Indications Growing

    Jain says some clinics now use ICSI routinely in couples who have failed prior IVF attempts or in those with few or poor-quality eggs, even when semen measurements are normal. He adds that a few clinics even advocate the routine use of ICSI for all IVF attempts.

    Society for Assisted Reproductive Technology President David Grainger, MD, says there is little evidence that the practice improves success rates for couples without a diagnosis of male infertility.

    “I can find very little medical justification for performing ICSI 100% of the time,” he says.

    He says the report raises legitimate questions about the increasing use of ICSI, but he adds that limitations in the surveillance data used in the study make it difficult to draw conclusions about the frequency of use in men with normal sperm.

    “Generally patients have more than one diagnosis, and that may not be reflected in the reporting,” he says. “Diagnosis with regard to IVF is not usually inaccurate, but it is often incomplete.”

    • Struggling with male infertility issues? Pose your questions to our WebMD expert, Sheldon Marks, MD, on the Male Factor Infertility message board.

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