New figures on assisted reproduction technology in Europe show that there has been an explosion in the use of ICSI (intracytoplasmic sperm injection) to treat infertility. Researchers believe that some countries may now be using the procedure too often. In 2005, the most recent year for which data is available, the number of ICSI cycles was nearly double the number of standard IVF cycles. In 1997 the proportion was reversed.

The distribution of IVF and ICSI has undergone a complete reversal from 65.3% for IVF and 34.75 for ICSI in 1997 (when ART data first started to be collected for Europe), to 36.7% for IVF to 63.3% for ICSI in 2005. In southern Europe it is used as much as 81% of the time.

Originally ICSI was used when a man had a very low sperm count or poor sperm motility. Viable sperm are injected directly into an egg. But it is more complicated and more expensive, so doctors are puzzled by its rapid increase. Pregnancy rates are the same and it is often being done even when there is no male fertility problem.

One reason may be its profitability. As ICSI is more complicated than IVF, it is also 10% to 30% more expensive. Professor Nyboe Andersen, of the European Society for Human Reproduction and Embryology, says that doctors may want to show couples that they had tried every available procedure, including the most advanced, to achieve a pregnancy. "This is understandable, but except in cases of male factor infertility, ICSI is unnecessarily complicated and more expensive." ~ ESHRE, July 9