ICSI (intracytoplasmic sperm injection) is a variation of in vitro fertilization (IVF), when a single sperm is inserted directly into an egg to fertilize it. It becomes increasingly popular among patients seeking infertility treatment. So popular, that some clinics offer this add-on procedure to patients who don’t actually need it just to earn extra money – we covered this trend recently. Global and European figures show that almost 70% of all reported cycles were ICSI in 2015.
ICSI was developed in the 1990s for the treatment of specific male infertility cases, when the sperm count and mobility was so low that an egg couldn’t be fertilized even in Petri cup. And if earlier it was used only for those specific cases, now ICSI cycles outnumber conventional IVF cycles by around two to one. In some countries, predominantly in Middle East, all assisted reproduction cycles are ICSI.
There was one study in Barcelona that ICSI has no better, and now there is another one – much larger. The scientists from the University Hospital Brussels, that same center where ICSI was developed 25 years ago, in collaboration with 14 IVF clinics in Spain studied 5,000 patients being treated with ICSI and standard IVF.
The results showed no difference between ICSI and IVF in terms of fertilization rate and cumulative live birth rate. Moreover, the results were similar for patients who had fewer eggs retrieved, from 1 to 3, as well as those, who produced more than 15. Considering that many clinics suggest ICSI when the response to ovarian stimulation is poor, these findings are very important, confirming that ICSI will not improve outcome in cycles in which only a few eggs were retrieved. Hence, the number of oocytes has no value in the selection of the insemination procedure in cases of non-male infertility.
"The rationale for ICSI being so popular seems to be that ICSI is associated with a higher likelihood of fertilization and an increased number of embryos – but this is controversial. This study for the first time aimed to provide the evidence of non-existent correlation of ICSI with a number of eggs retrieved using a large sample size," said the author of the research Dr Drakapoulos.
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