Do you really need ICSI?

images-6If you’d seen the Daily Mail headline earlier this week suggesting that the “Most popular form of IVF given to thousands of couples is ‘ineffective’“, you may well have been worried. In fact, the headline was referring to ICSI which is far from ineffective as a treatment for male fertility problems, and has allowed many men who would otherwise have had to use a donor to have their own genetic child.

The story in the Mail concerned the fact that ICSI isn’t an effective treatment in other cases, and it said that the editor-in-chief of the Human Reproduction journal, Professor Hans Evers, had criticised IVF clinics for offering ICSI to couples who will not benefit from it.

The fact that ICSI isn’t for everyone is not news. The NICE guidance in 2013 made it clear that ICSI should only be used where there were male fertility problems although it could also be considered where previous fertility treatment had resulted in failed or very poor fertilisation. ICSI is sometimes offered more widely, but there is no evidence that this would increase the chances of IVF working, and some research has suggested that it could actually reduce the chances of pregnancy where there is no indication that it is needed.

If you have male factor problems, you can ignore this as ICSI may well be the most effective treatment for you. If you are being offered ICSI where there are female issues or unexplained infertility, then you should make sure you talk to the team treating you about this before going ahead.