Intracytoplasmic sperm injection (ICSI): risks reconsidered

The aim of this article is to address some of the questions raised by the introduction of new techniques to alleviate infertility, using intracytoplasmic sperm injection (ICSI) as an example. Although any new technique has the potential to cause unanticipated harm and it is probably true that no treatment is risk-free, current practice demands that risks are, as far as possible, minimized during trials and when offered as treatment. It is expected that those taking part in trials, possibly even more than patients, should be given information on potential hazards so that they may choose whether to participate. However, particular problems arise when dealing with techniques to assist reproduction, since there may be risks not only to the recipients of treatment but also to the children who may result from the treatment. Therefore, risks to the children, as much as to the parents, deserve consideration and these potential subjects of risk will be the focus of this article. The different types of risk will be considered and the issue of whether children can be regarded as being harmed as a result of being conceived by such procedures will also be explored.