In recent years there has been an explosive increase in the incidence of Male Infertility. In tandem with this, there has also been a concomitant rise in the need for ICSI to help couples have a baby.

Yet ICSI is only a recent development in the field of reproductive medicine, having only been developed in the early nineties. So what did doctors and patients do before the ICSI era to counter male infertility?

The widespread availability of ICSI has reduced our focus on medical and lifestyle means to address this problem. General measures such as the reduction of body weight in obese men, cessation of smoking and alcohol, and good nutrition used to be the first line of treatment. Medical treatment, either with pharmaceutical medicines or herbal alternatives was the second line of therapy. With these two measures, a significant proportion of men were able to father children naturally.

At our clinic, we still focus on these relatively easy measures in an initial attempt to help improve sperm parameters, and only recommend ICSI if these measures fail to show benefit. Even when ICSI becomes necessary due to very poor sperm, there is good evidence to show that lifestyle and nutrition play a very important role in ensuring a good outcome. It appears that a combination of vitamins, minerals and antioxidants prevent damage to the DNA of sperm (the genes) and hence the sperm selected for injection into the egg by ICSI will be more “healthy” and give significantly better embryos.

As ICSI is an expensive treatment modality, it should be reserved as the last line of treatment, after easier alternatives have failed.