{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:56:02Z","timestamp":1773014162431,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003122","name":"Ferring","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003122","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100016055","name":"Mercy Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Intracytoplasmic sperm injection (ICSI) was first developed to overcome male factor infertility. ICSI has increased in uptake globally, including in cases where its use is non\u2010essential for fertilisation.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n To identify temporal trends in the use of, and indications for ICSI in an Australian context.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n A statewide descriptive cohort study examining the trends in ICSI uptake and reported indication\/s for ICSI use. The cohort included women undergoing IVF between 2005 and 2017 at IVF clinics across Victoria, Australia that resulted in a birth after 20\u2009weeks' gestation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The dataset comprised 32\u2009102 assisted reproduction cycles: 22\u2009873 (71.3%) ICSI and 9229 (28.7%) conventional IVF. In 2005, ICSI accounted for 60.6% (1182\/1952) of cycles, increasing to 79.5% (2344\/2947) by 2017 (\n p<\/jats:italic>\n trend<\/jats:sub>\n <\u20090.001). Testicular sperm retrieval as an indication for ICSI remained consistent over time (\n p<\/jats:italic>\n trend<\/jats:sub>\n \u2009=\u20090.15). Male factor infertility as an indication decreased over time (\n p<\/jats:italic>\n trend<\/jats:sub>\n \u2009=\u20090.007). Vitrified oocyte thaw (\n p<\/jats:italic>\n trend<\/jats:sub>\n \u2009=\u20090.016) and \u2018unexplained subfertility\u2019 (\n p<\/jats:italic>\n trend<\/jats:sub>\n \u2009=\u20090.30) cycles did not surpass 1.7% (39\/2293) and 0.4% (9\/2048), respectively of total cycles in any year. Donor sperm (\n p<\/jats:italic>\n trend<\/jats:sub>\n \u2009=\u20090.001), pre\u2010implantation genetic testing (\n p<\/jats:italic>\n trend<\/jats:sub>\n \u2009=\u20090.004), female factors associated with poor IVF outcome (\n p<\/jats:italic>\n trend<\/jats:sub>\n \u2009=\u20090.005) and advanced maternal age (\n p<\/jats:italic>\n trend<\/jats:sub>\n \u2009=\u20090.005) all increased as indications for ICSI over time. \u2018Unspecified\u2019 indication accounted for the majority of ICSI cycles after 2008 (\n p<\/jats:italic>\n trend<\/jats:sub>\n \u2009=\u20090.015).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n During our study period, the total use of ICSI increased by 18.9%. Notably, most of these cycles were not medically indicated.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ajo.70070","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T22:40:26Z","timestamp":1762382426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in the Use and Indications for Intracytoplasmic Sperm Injection Between 2005 and 2017: A State\u2010Wide Descriptive Cohort Analysis"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6034-2833","authenticated-orcid":false,"given":"Aleah","family":"Kink","sequence":"first","affiliation":[{"name":"Melbourne Medical School The University of Melbourne Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parinaz","family":"Mehdipour","sequence":"additional","affiliation":[{"name":"Melbourne Medical School The University of Melbourne Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Hiscock","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Newborn Health The University of Melbourne Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8756-3994","authenticated-orcid":false,"given":"Beverley J.","family":"Vollenhoven","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University Clayton Victoria Australia"},{"name":"Monash IVF Clayton Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catharyn J.","family":"Stern","sequence":"additional","affiliation":[{"name":"Reproductive Services Unit The Royal Women's Hospital Parkville Victoria Australia"},{"name":"Melbourne IVF East Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan P.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Newborn Health The University of Melbourne Parkville Victoria Australia"},{"name":"Mercy Perinatal, Mercy Hospital for Women Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark P.","family":"Green","sequence":"additional","affiliation":[{"name":"Monash IVF Clayton Victoria Australia"},{"name":"School of BioSciences The University of Melbourne Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiki","family":"Osianlis","sequence":"additional","affiliation":[{"name":"Newlife IVF East Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franca","family":"Agresta","sequence":"additional","affiliation":[{"name":"Melbourne IVF East Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"City Fertility Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Newborn Health The University of Melbourne Parkville Victoria Australia"},{"name":"Mercy Perinatal, Mercy Hospital for Women Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4342-1943","authenticated-orcid":false,"given":"Roxanne","family":"Hastie","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Newborn Health The University of Melbourne Parkville Victoria Australia"},{"name":"Mercy Perinatal, Mercy Hospital for Women Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber L.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Newborn Health The University of Melbourne Parkville Victoria Australia"},{"name":"Newlife IVF East Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8662-5188","authenticated-orcid":false,"given":"Anthea C.","family":"Lindquist","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Newborn Health The University of Melbourne Parkville Victoria Australia"},{"name":"Mercy Perinatal, Mercy Hospital for Women Heidelberg Victoria 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