PROGRESS https://www.progress.org.uk the independent charity that examines choices for people affected by infertility and genetic conditions held an event to look at the latest evidence on this critical issue with perspective from various clinicians who work in the field. The event was summarised in an excellent article in Bionews its flagship publication 7 November 2022 by Melinda Van Kerckvoorde

TITLED 30 Years of ICSI: An Injection of Hope for Male Infertility looked at what’s happened since the technique which inserts a single sperm into a single egg resulted in the first birth of a baby conceived by this method in 1992. It offered hope for couples who would until then have had no other treatment option – other than to consider donor sperm.

ICSI since then has helped couples have their own baby where there are severe sperm problems e.g. when the man has hardly any sperm, or its of poor quality and sperm don’t swim well.

But it’s being used increasingly for couples where the man has just mild sperm problems and is now used more often than conventional IVF. ICSI is used now in two-thirds of assisted reproduction cases worldwide e.g. for couples with unexplained infertility, older maternal age or seemingly for no reason. ICSI being used as a blanket treatment in IVF clinics for fear of treatment failure.

But there are problems/issues linked to ICSI e.g. increased risk of birth defects, childhood cancer, queries over ICSI’s use and the increase in autism spectrum disorders. The report which highlights the increasing domination of financial interests in the medical world concludes the way forward is to have more openness and collaboration in assisted reproduction techniques, better couple counselling about the risks involved in the technique. More research and practice is needed to discover when and for whom ICSI is appropriate.