ICSI more common than IVF in Europe, children more intelligent

BioNews reporting from ESHRE conference, Copenhagen: The European Society of Human Reproduction and Embryology (ESHRE) has shown that, for the first time, the use of ICSI (intracytoplasmic sperm injection) has overtaken normal IVF procedures as a method of treating infertility in Europe. This suggests that infertility may be becoming more of a male problem, when previously 80 per cent of infertility has been found to be equally shared between men and women, with 20 per cent unexplained or due to joint causes.

Data revealed at the ESHRE annual conference in Copenhagen, Denmark, shows that ICSI overtook IVF as the most commonly used assisted reproductive technology in Europe in 2002. ICSI differs from IVF in that a single sperm is injected directly into an egg. It is used primarily when either just the male in a couple, or both parties, have fertility problems - for example, a very low sperm count or poor sperm mobility.

Dr Anders Nyboe Andersen, of the Rigshospitalet at Copenhagen University in Denmark, presented preliminary data from the ESHRE European IVF Monitoring Programme for 2002 at the conference. This data - representing 24 European countries - showed that while nearly 113,000 IVF treatment cycles were performed, more than 122,000 cycles of ICSI took place in the same period. The proportion of ICSI has been rising steadily since the collection of data began, and in 2002 stood at 52 per cent of all treatments. Dr Andersen said that it was not really known why the use of ICSI was on the rise, but speculated that the 'relative causes of infertility' could be shifting. 'Male subfertility seems to be increasing', he said, adding: 'Perhaps the data on declining sperm quality are true, and maybe environmental factors are playing an increasing role as the planet becomes more polluted and factors that disrupt the endocrine system enter the food chain'. Another reason he suggested was a more general improvement in ICSI techniques, since its first successful use in 1992. 'It is also possible that as ICSI techniques have improved, patients and doctors are voting with their feet and using it in ever increasing numbers, despite any residual fears about its safety and the health of ICSI babies', said Andersen.

Another study presented at the conference, which looked at children born following the use of ICSI, suggests that children conceived this way are slightly more intelligent than other children. Some previous studies have reported slight developmental delays - in both cognitive and motor functions - in children born after ICSI. Now, a research team led by Lize Leunens, from the Free University of Brussels, Belgium, has compared the intelligence and motor skills of 151 eight-year old ICSI children with those of 153 naturally conceived children of the same age. The researchers found no difference in motor skills, and that the ICSI children scored slightly higher on intelligence tests than those conceived naturally. Leunens told the meeting that 'we can be pretty sure that in the long term these children are not suffering any developmental delays'. She added, in common with previous suggestions, that the most likely explanation for the finding is that mothers of ICSI children might provide more stimulation and spend more time interacting with their children. 'These mothers might be particularly dedicated to parenting', she said.