Non-justified Use of ICSI (Specialized IVF Technique) for ART?


Does assisted reproductive technology (ART) resort too often to the use of unnecessary and costly techniques?

In a recent study published in the Lancet, Australian researchers investigated this issue, especially focusing on the technique of intracytoplasmic sperm injection, known as “ICSI”.

They assert that in most cases, standard in vitro fertilization (IVF) is sufficient. In the conventional IVF technique, the woman undergoes ovarian stimulation followed by an ovarian puncture to collect a sufficient number of eggs, if possible, to perform in vitro fertilization, simply by pooling the eggs with the spouse’s sperm.

Since 1992, the so-called “ICSI” technique has also been employed. It is comparable to forcing the sperm inside the egg, via a micro-pipette. The ICSI technique was developed for situations of male infertility where the sperm count is extremely low. In this case, the natural selection of the sperm by the egg is obliterated.

Although conventional IVF is adequate, ICSI is being used increasingly throughout the world, even though it involves additional costs and unjustified risk-taking.

According to Robert Norman, Professor of Reproductive Medicine at the University of Adelaide and Ben W. Mol, Professor of Gynecology and Obstetrics “In  the United States, between 1996 and 2012, ICSI use increased from 15% to 67% of couples where the male has a normal sperm count. In Australia, about 60% of cycles used ICSI in 2018. In Europe, about 70% of cycles use ICSI.”


The use of ICSI continues to become more and more widespread, even for cases unrelated to male infertility. Even though, as the study shows, the ICIS technique does not improve in vitro fertilization success rate when there is a normal sperm count.

Between March 16, 2018, and August 12, 2019, the researchers studied 1,064 couples who requested assisted reproductive techniques. Using random allocation, 532 fertilizations were done with ICSI, compared to 532 with conventional IVF. Couples in either group were just as likely to have a baby with a success rate of 35% for couples in the ICSI group, and 31% in the conventional IVF group.

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