Extreme Form of IVF Overuse may Pass Infertility to Next Gen

by Trilok Kapur on  February 24, 2010 at 11:26 AM Research News   - G J E 4
 Extreme Form of IVF Overuse may Pass Infertility to Next Gen
The pioneer of an extreme form of IVF that forces individual sperm into eggs, has warned that if the technique is overused, it may pass on infertility to the next generation.

A conference was told that the fertility treatment designed for use with poor quality or low numbers of sperm is being used too widely despite the risks it may pass on infertility to the offspring.

Normal In-Vitro Fertilization (IVF) treatment is where the sperm and eggs are mixed together in a dish and the sperm breaks into the egg on its own in order for fertilization to occur.

The newer more advanced method called Intra-cytoplasmic sperm injection (ICSI) involves the embryologist injecting a single sperm directly through the shell of the egg and depositing it inside.

Abnormal sperm, which would normally be filtered out by the process, are able to fertilize the egg thanks to the extra intervention.

Since its introduction in 1992, increasing numbers of fertility clinics have adopted ICSI as their procedure of choice. Around half of the cycles conducted in British clinics use this method.

However some experts have concerns about the treatment. Since it overcomes the barrier of male infertility, there are fears that genetic defects, which would normally prevent conception, might be allowed into the embryo.

An Australian study published in The Lancet medical journal two years ago suggested that ICSI increased the risk of delayed mental development in one-year-olds.

This conflicted with other evidence showing no sign of slowed mental development by the age of two.

The first ICSI pregnancies 18 years ago were achieved by a Belgian team led by Professor Andre Van Steirteghem from the University of Brussels.

Speaking at the annual meeting of the American Association for the Advancement of Science in San Diego, California, he said he believed ICSI was being used too often.

"I have noticed from the beginning that several clinics use ICSI for everyone," the Telegraph quoted Prof Van Steirteghem as saying.

"I don't think it's necessary when you have methods like conventional IVF which is certainly less invasive, and can help couples with female factor or idiopathic (no known cause) infertility when the sperm count is normal.

"I don't see any reason why ICSI should be used in these situations.

"We have to see what will come out in the future, and long term follow up is extremely important, but yes, ICSI has been overused," he said.

One criticism of assisted conception techniques - ICSI in particular - has been that genetic causes of infertility might be passed on to offspring.

Prof Van Steirteghem was asked if he believed IVF might be storing up infertility problems for future generations.

"Well, yes. The answer to that is maybe yes," he answered.

"There are genetic causes of infertility that you can bypass with assisted reproductive technology, but that may mean that the next generation may be infertile as well.

"This is something that all clinics should mention to patients," he stated.

Agreeing to Prof Van Steirteghem's views was Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield.

"I agree that there is a real danger that ICSI is being overused in some parts of the world and I suspect this is out of fear of patients experiencing 'failed fertilization' using conventional IVF," Pacey said.

"The problem of overusing ICSI is that there is a very small but statistically significant increased risk that some of the babies born from the technique appear to have health problems.

"As such the sensible thing is to only use ICSI when absolutely necessary.

"I sense that on the whole UK practitioners are very aware of the dangers of overusing the technique and it is difficult to say whether the UK could get away with using it less frequently.

"The fact that so many patients pay for their own treatment and that we seem to be so obsessed with league tables are two big factors that work against ICSI being used less often," he added.

Source: ANI

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