ICSI Male Infertility Treatment Up
Dramatic 5-Fold Increase Coupled With IVF During Last Decade
July 18, 2007 - The percentage of infertile men in the U.S. does not appear
to have changed much over the last decade, but there has been a fivefold
increase in the use of a specialized procedure during IVF for male-factor
infertility, new research shows.
The study of national trends in infertility treatment showed a dramatic jump
in the use of intracytoplasmic sperm injection, or ICSI, in couples undergoing
in vitro fertilization (IVF).
In 1995, just 11% of IVF cycles included ICSI, but the percentage had risen
to 57.5% a decade later.
The report appears in the July 19 issue of the New England Journal of
The findings suggest ICSI is increasingly being used in conjunction with IVF
for conditions other than male-factor infertility, says researcher Tarun Jain,
MD, who is an assistant professor of reproductive endocrinology and infertility
at the University of Illinois, Chicago.
Jain tells WebMD that it is not clear if the benefits derived from ICSI
justify the added cost and potential risks for couples without a diagnosis of
“Those studies haven’t been done,” he says. “More research is needed to
determine if routine use of ICS for nonmale factor conditions is
IVF, ICSI, and Male Infertility
Next year marks the 30th anniversary of the conception of the first human
outside the body through IVF, a procedure in which egg is introduced to sperm
in a Petri dish.
The first effective treatment for male infertility, characterized by poor
quality or quantity of sperm, became available in 1992.
Rather than relying on the sperm to penetrate the egg on its own, ICSI
involves direct injection of a single sperm into the egg.
ICSI adds about $1,500 to a single cycle of IVF, which averages about
$12,400, according to figures from the American Society for Reproductive
In their effort to assess trends in the use of IVF, with and without ICSI,
Jain and colleague Ruchi Gupta, MD, MPH, of Northwestern University, analyzed
national reporting data on assisted reproduction between 1995 and 2004.
The analysis included all reported IVF cycles involving fresh embryos from
nondonor eggs in women during the 10-year period. From 1995 to 1998, the data
included all ages, but from 1999 to 2004 data were limited to women younger
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 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