Survival of the unfittest: IVF technique 'used too widely', watchdog warns

Injecting sperm may raise chances of conception but lead to fertility problems in next generation

A technique for injecting sperm directly into unfertilised eggs to increase the chances of a successful IVF pregnancy is being used too widely by some fertility clinics, the head of the Government's fertility watchdog has warned.

Lisa Jardine, who chairs the Human Fertilisation and Embryology Authority (HFEA), said that some IVF clinics are using intracytoplasmic sperm injection (ICSI) simply because it is easier than standard IVF, rather than because it is in the best interests of patients.

"We believe it is being used far too widely because it is procedurally easy," Professor Jardine said. "The scientists who advocate it already know that a boy born through ICSI is likely to have a low sperm count. So it is a little bit worrying that it is being rolled out so widely."

She recently warned on BBC Radio 4 that success rates for couples, who typically spend around £15,000 for three cycles of treatment, are "discouragingly low".

ICSI was first introduced about 20 years ago, since when its use has become widespread. In 2011, more than half of the nearly 62,000 cycles of fertility treatment, involving just over 48,000 women in Britain, were done with ICSI, rather than letting the sperm penetrate the egg naturally.

In many other countries – in North America and Europe for instance – the figure is even higher, with ICSI being used in as many as 90 to 95 per cent of IVF cycles. Yet some studies suggest that IVF children born from ICSI may be at higher risk of medical problems as they grow older, including male infertility.

"We know that babies born from ICSI have increased risk of some problems later in life and infertility is one of them," said Allan Pacey, chairman of the British Fertility Society and an IVF specialist at Sheffield University.

"For these reasons we should be prudent over the use of ICSI. So let's use ICSI when it's needed, and not as some kind of guarantee against fertilisation failure, which is how some clinics approach it."

Professor Jardine, who steps down as chair of the HFEA in the new year, said she shares the concerns of some experts, who believe that many fertility clinics are opting to use ICSI simply because it is easier to achieve rapid fertilisation of an egg, rather than using it specifically as a treatment for male infertility.

About half of the couples given ICSI have male-related fertility problems, while about 12 per cent have joint male and female factors, and 10 per cent have specifically female fertility problems. In 20 per cent of cases, ICSI is used for "unexplained" reasons, according to data gathered by the HFEA.

One of the pioneers of ICSI, André Van Steirteghem of the Brussels Free University Centre for Reproductive Medicine, warned in 2010 that IVF clinics are routinely overusing the treatment despite the risk of long-term health problems in the children conceived by the technique.

"The health of children has to be considered the most important outcome of artificial reproductive technology treatment. It's fair to say that overall these children do well [but] there are a few more problems with these children," Dr Van Steirteghem said.

"It doesn't mean that when you use ICSI there will be more problems, but it is important that we have to see what comes about in the future, so long-term monitoring is extremely important. ICSI has been overused," said Dr Van Steirteghem. He advises the HFEA on new developments in fertility treatment.

However, Professor Pacey said that Britain is one country that is probably not overusing ICSI overall: "As a country overall we've got it about right, because about half of the fertility problems are male related and half are female related, and there is a 50:50 split between ICSI and conventional IVF."

"But there may be some individual clinics that are doing it more than they should. They are frightened of fertilisation failing. The HFEA should be focusing on these individual clinics with high ICSI levels," he added.

Start your day with The Independent, sign up for daily news emails
PROMOTED VIDEO
ebooks
ebooksA year of political gossip, levity and intrigue from the sharpest pen in Westminster
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Ashdown Group: Client Services Manager - Relationship Management - London

£30000 - £32000 per annum + benefits : Ashdown Group: A highly successful, int...

Recruitment Genius: Credit Controller / Customer Service

£18000 - £20000 per annum: Recruitment Genius: This rapidly expanding business...

Recruitment Genius: Electronics Engineers / Senior Electronics Engineers

£25000 - £55000 per annum: Recruitment Genius: Based in Henley-on-Thames, this...

Austen Lloyd: Private Client Solicitor - Oxford

Excellent Salary : Austen Lloyd: OXFORD - REGIONAL FIRM - An excellent opportu...

Day In a Page

Syria crisis: Celebrities call on David Cameron to take more refugees as one young mother tells of torture by Assad regime

Celebrities call on David Cameron to take more Syrian refugees

One young mother tells of torture by Assad regime
The enemy within: People who hear voices in their heads are being encouraged to talk back – with promising results

The enemy within

People who hear voices in their heads are being encouraged to talk back
'In Auschwitz you got used to anything'

'In Auschwitz you got used to anything'

Survivors of the Nazi concentration camp remember its horror, 70 years on
Autumn/winter menswear 2015: The uniforms that make up modern life come to the fore

Autumn/winter menswear 2015

The uniforms that make up modern life come to the fore
'I'm gay, and plan to fight military homophobia'

'I'm gay, and plan to fight military homophobia'

Army general planning to come out
Iraq invasion 2003: The bloody warnings six wise men gave to Tony Blair as he prepared to launch poorly planned campaign

What the six wise men told Tony Blair

Months before the invasion of Iraq in 2003, experts sought to warn the PM about his plans. Here, four of them recall that day
25 years of The Independent on Sunday: The stories, the writers and the changes over the last quarter of a century

25 years of The Independent on Sunday

The stories, the writers and the changes over the last quarter of a century
Homeless Veterans appeal: 'Really caring is a dangerous emotion in this kind of work'

Homeless Veterans appeal

As head of The Soldiers' Charity, Martin Rutledge has to temper compassion with realism. He tells Chris Green how his Army career prepared him
Wu-Tang Clan and The Sexual Objects offer fans a chance to own the only copies of their latest albums

Smash hit go under the hammer

It's nice to pick up a new record once in a while, but the purchasers of two latest releases can go a step further - by buying the only copy
Geeks who rocked the world: Documentary looks back at origins of the computer-games industry

The geeks who rocked the world

A new documentary looks back at origins of the computer-games industry
Belle & Sebastian interview: Stuart Murdoch reveals how the band is taking a new direction

Belle & Sebastian is taking a new direction

Twenty years ago, Belle & Sebastian was a fey indie band from Glasgow. It still is – except today, as prime mover Stuart Murdoch admits, it has a global cult following, from Hollywood to South Korea
America: Land of the free, home of the political dynasty

America: Land of the free, home of the political dynasty

These days in the US things are pretty much stuck where they are, both in politics and society at large, says Rupert Cornwell
A graphic history of US civil rights – in comic book form

A graphic history of US civil rights – in comic book form

A veteran of the Fifties campaigns is inspiring a new generation of activists
Winston Churchill: the enigma of a British hero

Winston Churchill: the enigma of a British hero

A C Benson called him 'a horrid little fellow', George Orwell would have shot him, but what a giant he seems now, says DJ Taylor
Growing mussels: Precious freshwater shellfish are thriving in a unique green project

Growing mussels

Precious freshwater shellfish are thriving in a unique green project