Developed in 1992, Intracytoplasmic sperm injection (ICSI) is a relatively new fertility treatment. ICSI is used in conjunction with in-vitro fertilization (IVF) procedure. During IVF, a woman has eggs removed from her ovaries and put into a laboratory dish with some sperm cells, in the hope that the sperm cells will fertilize the eggs. In ICSI, however, the sperm cells are injected directly into the eggs to give them a better chance of achieving fertilization. This technique has given hope to men with low sperm cell counts or abnormally weak, low quality sperm.
As the treatment is a recent development in assisted reproduction technology, there has been some speculation as to the possible risks to the health and development of children born thanks to this technique. Such worries include:
A higher risk of miscarriage during ICSI pregnancies - given that such pregnancies are initiated by sperm cells that would have been too weak to fertilize an egg naturally. There may therefore be some inherent defect in these sperm cells which will lead in the creation of unviable embryos.
Generational transmission of infertility - some experts are concerned that it may turn out, in the longer term, that boys born via ICSI, whose father's sperm cells were not capable of natural fertilization, may themselves be infertile as adults.
Fertility specialists agree that long-term monitoring of the health of ICSI children is to establish whether or not these fears are well-founded. This monitoring process is already underway.
There is indeed some evidence of problems associated with ICSI, but these problems have also been linked to IVF. Therefore it is not necessarily true that ICSI is any riskier. It's also worth bearing in mind that such problems may be due to the underlying reasons for a couple's infertility, and may therefore have no connection to the fertility treatment used. Such problems include:
Genetic and developmental defects in an extremely small number of children born through IVF and/or ICSI.
The risk of multiple pregnancy (having twins, triplets, or more) - can lead to low birth weight in babies, which is linked to developmental problems. A multiple pregnancy can also pose risks to the mother, such as high-blood pressure and gestational diabetes. Both these conditions can have repercussions for the babies during pregnancy and post-partum.
Making Sense Of It All
At 2010's AAAS (Advancing Science Serving Society) conference in San Diego, United States, fertility experts from around the world emphasized that overall, IVF and ICSI children are doing well in terms of their health and growth. They agreed that more studies need to be done on these children because the data available is still insufficient to make conclusions about long-term health issues. This particularly applies to ICSI boys and their future fertility - the oldest boys born through ICSI are by now in their late teens, meaning that the majority of them have not yet tried to become fathers themselves.
A Belgian fertility specialist Andre Van Steiteghem, did, however, put forward the argument that ICSI is being overused. He believes that the technique should be reserved only for couples in which the male partner's poor sperm quality is the reason for the failure to conceive. He criticized fertility clinics for offering ICSI automatically as an IVF "booster" to couples with unexplained infertility, or couples in which the male partner's sperm count is normal.
Speak To Your Specialist
On the whole, most infertile couples seem to feel that the benefits of ICSI - i.e. the chance to become parents - outweigh the risks. However, each case of infertility should be assessed individually. To get the best advice for you, discuss your options with your fertility specialist.