Can Fertility Treatments be Over-used?

According to the scientist who developed one of the most widely used types of fertility treatments for infertile men, his technique is used too frequently. The fertility clinics that are over-using intra-cytoplasmic sperm injection (ICSI) as a means of helping men realize their dreams of fatherhood, are putting their patients at unnecessary risk and expense.

The Numbers Tell the Story

In 1991 Andre van Steirteghem of the Free University of Brussels led the team that invented the ICSI procedure. The revolutionary treatment involving the injecting of a sperm directly into an egg rescued men with poor-quality sperm from the despair of not being able to produce their own biological children. However, by all accounts, the treatment is being used inappropriately and indiscriminately on couples who don't need it.

In Europe, in just over a decade, (1995-2007) the number of in vitro fertilization cycles involving ICSI have increased by 66% and in the UK, in the same period of time, ICSI usage rose from 15% to 48% of IVF cycles, with even higher percentages in some clinics. Britain's Assisted Reproduction and Gynaecology Centre in London, where the success rates of IVF are the highest, uses ICSI in 78% of treatments.

Used When it Shouldn't Be Used

Dr. van Steirteghem's concern is that ICSI is being used to treat everyone when conventional IVF, which is less invasive than ICSI, would be very suitable for men with normal sperm. Using the therapy in situations where sperm is normal is unnecessary and expensive. ICSI can cost up to 30% more than standard IVF, which costs about 3,500 Pounds without ICSI. When ICSI is added, the price goes up another 1,000 Pounds. In standard IVF procedure, the sperm are allowed to swim up to an egg in order to fertilize it. ICSI treatment injects a sperm into an egg at an increased risk for producing children with birth defects.

Risk to Little Boys

There is an added concern that children conceived with this technique using sperm that is not robust enough to fertilize an egg may encounter longer-term health problems. Boys born through ICSI are at risk for infertility when they mature since the genetic traits that weakened the father's sperm can be passed on to the child. Dr. van Steirteghem's recommendation is that children conceived using ICSI should continue to be followed up, especially since the oldest of these children are not yet twenty. There may not be any problems, but it is important to know what will come out of the therapy in the end.

Table of Contents
1. Overuse of ICSI
2. And if sperm is inferior?
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