ICSI for non-male infertility: from ineffectiveness to gender bias?

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online Pub Date : 2025-03-01 DOI:10.1016/j.rbmo.2024.104706

Edgardo Somigliana , Giussy Barbara , Laila G. Micci , Giorgia Di Stefano , Alessio Paffoni , Paola Vigano

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引用次数: 0

Abstract

Intracytoplasmic sperm injection (ICSI) is currently being abused as it is also frequently employed in the absence of a frank male cause of infertility. There is growing and robust evidence showing that the use of ICSI should be limited to couples with male infertility. For all other causes of infertility, the procedure does not increase the chance of live birth, may increase malformations in newborns and requires more resources than conventional IVF. In addition, the use of ICSI may impact the sex ratio at birth, favouring female infants. Even if this effect may not be targeted as a gender biased procedure, it should be seen as a wake-up and warning call. It reminds us that ICSI is a ‘non-natural’ invasive technique that circumvents natural sperm selection mechanisms. Overall, a policy of indiscriminate use of ICSI is not justified and a plea is made for a return to a higher use of conventional IVF. Fear about failed fertilization or the use of preimplantation genetic testing for aneuploidies may represent barriers to the need to lower ICSI use and should be overcome.

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来源期刊

Reproductive biomedicine online 医学-妇产科学

CiteScore

7.20

自引率

7.50%

发文量

391

审稿时长

50 days

期刊介绍： Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.