Technique for Male Infertility on the Rise

Ivanhoe Newswire
Monday, July 23, 2007; 12:00 AM

(Ivanhoe Newswire) July 23, 2007 -- New research shows the use of a specific technique to help men with infertility problems in the United States has seen a dramatic increase since 1995. The research shows the increase has occurred even while the number of patients receiving treatment for male infertility has remained stable.

Researchers from the University of Illinois at Chicago studied the use of a technique called intracytoplasmic sperm injection (ICSI) for male infertility. ICSI involves the direct injection of sperm into eggs obtained from in vitro fertilization (IVF). The research team also compared the use of ICSI in states with and without mandated insurance coverage for infertility treatment.

Results of the analysis show between 1995 and 2004, the percentage of IVF cycles that used ICSI rose sharply from 11 percent to 57.5 percent.

Tarun Jain, M.D., from the University of Illinois at Chicago, was quoted as saying, "Despite its added cost and uncertain efficacy and risk, the use of ICSI has been extended to include patients without documented male-factor infertility."

Dr. Jain found states that have mandated insurance coverage for infertility (Illinois, Massachusetts and Rhode Island) were more likely to use ICSI for reasons other than male infertility when compared to states without mandated insurance coverage. Dr. Jain writes, "ICSI is an expensive procedure from the perspective of patients and third-party payers, and it requires considerably more medical resources and laboratory time than conventional IVF."

Dr. Jain believes doctors may be using ICSI in patients who have failed to conceive and deliver a baby with previous IVF cycles or in those who have few eggs available. The concern, says Dr. Jain, is that few studies have been done to determine whether or not the routine use of ICSI has risks like genetic and congenital disorders for babies.

Authors of the study conclude, "The use of ICSI in the United States has been steadily increasing over a 10-year period, and ICSI has been performed in the majority of IVF cycles since 2001, even though the percentage of diagnoses of infertility attributed to male-factor conditions has remained stable."

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SOURCE: The New England Journal of Medicine, 2007;357:251-257