"Intracytoplasmic sperm injection (ICSI) has made conception possible for many couples with male factor infertility and a previously bad prognosis, but, as for all other reproductive technologies ICSI must be safe as well as effective," she said.
Concern at findings this year in an Australian study of ICSI prompted ESHRE to examine the totality of the evidence. Dr Wennerholm and her colleague Professor Christina Bergh, both from the Department of Obstetrics and Gynaecology at the Institute for Health of Women and Children in Sahlgrenska University Hospital in Gteborg, Sweden, carried out the review.
"From the beginning ICSI has been considered a more risky procedure than conventional IVF, but so far the majority of later studies found no increase in congenital malformations in children born after conventional IVF or ICSI," said Dr Wennerholm.
An alarmingly high prevalence of major birth defects after ICSI and IVF was found in the Australian register study** with the figure being twice as high for ICSI and IVF children as for normally conceived children - 8.6% of 301 infants conceived with ICSI and 9% of IVF children compared with 4.2% of normally conceived babies. "However, a major problem with this study was that it contained only a small number of ICSI and IVF children," said Dr Wennerholm.
At the same time, a recent Belgian*** study comparing children born after ICSI and IVF concluded that the major malformations between the two groups were comparable. The study lacked a naturally conceived control group but the rates were comparable to the naturally born children in the Australian study.
In Sweden,**
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Contact: Margaret Willson
m.willson@mwcommunications.org.uk
European Society for Human Reproduction and Embryology
1-Jul-2002