Associate Professor Alex Polyakov, Medical Director of Genea Melbourne, has published research revealing widespread and unnecessary use of ICSI (Intracytoplasmic Sperm Injection) in Australia, raising important questions about appropriate treatment selection for couples undergoing fertility care.
Alex's study highlights that ICSI is being used far more extensively than clinically warranted, with questionable benefits for couples without severe male infertility. His research suggests that roughly 30 per cent of couples would genuinely benefit from ICSI for male-factor infertility, whilst conventional IVF remains more effective for those with normal semen analysis.
The distinction between these two approaches is significant. Alex explains that conventional IVF allows for a natural sperm selection process, where sperm compete to fertilise the egg, mimicking natural conception. In contrast, ICSI involves laboratory-selected sperm being directly injected into the egg—a technique that was originally developed for cases of severe male infertility.
The overuse of ICSI has important implications beyond just clinical effectiveness. The procedure adds unnecessary financial burden to couples already facing the significant costs of fertility treatment. Additionally, there are potential health considerations associated with ICSI that may not be warranted when male fertility is normal.
Alex's research prompts calls for more judicious use of ICSI, ensuring the procedure is reserved for cases where it provides clear clinical benefit—specifically for couples with severe male-factor infertility. For couples with normal semen parameters, conventional IVF offers an effective, less invasive, and more cost-effective approach.
This study reflects Genea's commitment to evidence-based fertility care and ensuring patients receive the most appropriate treatment for their specific circumstances. By highlighting the overuse of ICSI, Alex advocates for a more tailored approach to fertility treatment that considers both clinical effectiveness and patient wellbeing.
The findings encourage fertility specialists to carefully evaluate each couple's unique situation and select the fertilisation method that offers the best outcomes whilst avoiding unnecessary interventions and costs.
A/Prof Alex Polyakov
Associate Professor Alex Polyakov is an Obstetrician, Gynaecologist and Fertility specialist practicing in East Melbourne. A/Prof Polyakov is unique among fertility specialists by offering a holistic approach that encompasses surgical, fertility, and obstetric care. This means Alex is highly trained to perform surgical interventions for gynaecological conditions such as fibroids, endometriosis, and intrauterine polyps/adhesions.
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