From the Associated Press:
08/02/2007
Fertility Clinics Gouging Patients With Costly Technique (Wired News)
A sperm-injection method that is effective for one type of infertility problem is being used across the board, doing little except bloating the bill.
The technique referred to in the above statement found on the Associated press is a technique called ICSI. This technique involves injecting the sperm into the egg and basically removes natural selection completely from the process of trying to create a healthy embryo artificially.
Normally with IVF eggs are taken from the female and put in a petri dish along with about 100,000 sperm that were obtained by the male. Then after a certain amount of time hopefully a fertilisation takes place. Hopefully it is the healthiest and strongest of the sperm then that has fertilised the egg. This would simulate what happens when the sperm meets the egg following intercourse.
With ICSI however the IVF specialists take the sperm that they think looks the best and inserts it directly in the egg. This has been done in the past when there has been certain issues with the sperm requiring ICSI.
It appears that "The percentage of IVF cycles that used ICSI increased dramatically during the 10 year time span from 11 % of procedures to 57.5 percent of procedures while the percentage of diagnosis for male factor infertility remained steady." This is reported by Dr. Tarun Jain assistant professor of reporductive endocrinology and infertility at the University of Chicago Illinois
He also adds "Further studies are needed to better understand the proper role of ICSI and and perhaps guidelines may be useful to determine what eh best indications are for the use of the technology in patients without male factor infertility".
It is also suggested that more studies need to be done regarding the possibility of assoicated risks such as genetic disorders and congenital anomalies when ICSI is used.
Stacey's comment:
I think the most important issue is that the patients involved should be explained what the procedures are and how they differ. Most patients that have had ICSI done without there being male factor fertility issues have said that their doctor told them the procedure was likely going to improve the chance for a fertilisation and have better pregnancy rates. Very few, if any, were given an explanation as to what the advantages and disadvantages were to the procedure and how it differed from a regular round of IVF.
This is especially important as patients are often having to pay out of pocket for their procedures (and complimentary programs) and adding ICSI in increases the bill.
Often times physicians will make the comment that taking herbs or supplements is just a waste of money but they don't often consider paying extra hundreds of dollars for a procedure that the patient is already paying thousands of dollars for as an issue.
At our clinic we strive to educate the patient so they can make decisions based on what they feel is best for their particular situation. It's important that they have all the facts to help them decide what procedures they feel comfortable with.
It isn't our place to make these decisions for the patient, but instead encourage them to do what they feel is best for themselves.
