A national study reveals that the use of intracytoplasmic sperm injection or ICSI -- an assisted reproductive technology used to treat male-factor infertility -- has increased dramatically in the United States since 1995, while the proportion of patients receiving treatment for male-factor infertility has remained stable.

"Despite its added cost and uncertain efficacy and risk, the use of ICSI has been extended to include patients without documented male-factor infertility," said Dr. Tarun Jain, assistant professor of reproductive endocrinology and infertility at the University of Illinois at Chicago and lead author of the study that appears in the July 19 issue of the New England Journal of Medicine.

The research also compared the use of ICSI in states with and without mandated insurance coverage for infertility treatment.

States with mandated insurance coverage for infertility (Illinois, Massachusetts and Rhode Island) had a greater use of ICSI for reasons other than male-factor infertility when compared to states without mandated insurance coverage.

The researchers analyzed national data on assisted reproductive technology during a 10-year time span from 1995 to 2004. The study included all in vitro fertilization cycles involving fresh embryos from non-donor eggs in women younger than 43.