ICSI associated with increase in Stillbirth Rate? What a Recent Danish Study Means

A recent Danish study reported a 4-fold increase in still births following IVF with intracytoplasmic sperm injection (ICSI).

In the past, intracytoplasmic sperm injection (ICSI) , an in vitro-fertilization method, has been used predominantly in cases of moderate or severe male factor infertility. More recently many IVF centers have applied ICSI as a preferred method of fertilization in non-male infertility cases, as well. It is well recognized that when ICSI is performed for male infertility there is a definite increase in embryo defects and related miscarriages.

A few years ago, a large study in Sweden (2003) followed by one reported from Egypt (2004) clearly showed that when ICSI is performed for non male factor infertility, IVF outcome is not prejudiced, and the rate of pregnancy loss and birth defects are unaffected.

Since the Danish study does not differentiate between cases where ICSI was done for male factor versus non male factor infertility, it is likely that their finding of an increase in still births might be due to the effect of abnormal sperm on the embryo’s health rather than being due to the ICSI process itself. And… since male factor infertility requires ICSI, there is no avoiding this procedure in such cases anyway.