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Omar Ammar: Is ICSI Associated with a Change in the Sex Ratio at Birth?

Omar Ammar/LinkedIn

Oct 3, 2026, 17:30

Omar Ammar: Is ICSI Associated with a Change in the Sex Ratio at Birth?

Omar Ammar, Founder and Owner of Al Manarah Medical Laboratory, shared a post on LinkedIn about a paper he co-authored with Michael P. Rimmer published in Scientific Reports։

“Is ICSI associated with a change in the sex ratio at birth?

In our analysis, yes. Slightly fewer boys were born after ICSI than after conventional IVF: 49.2% vs 52.6%.

We’re not the first to look at this. So what does our analysis add?

Using 164,684 singleton live births from the UK HFEA register between 2005 and 2018, we adjusted for maternal age, treatment year, number of embryos transferred, and fresh versus frozen embryo transfer.

The adjusted odds of a male live birth were lower after ICSI than after conventional IVF (OR 0.88, 95% CI 0.86–0.89), corresponding to adjusted male proportions of 49.2% after ICSI and 52.6% after IVF.

We then tested the association in several sensitivity analyses: restricting to single-embryo transfers, analysing cycles without recorded male-factor infertility, and excluding PGT and donor-gamete cycles. The association remained consistent.

Does this change what we tell an individual couple? No. The difference is small, and these observational data do not show that ICSI itself causes the shift. It should not drive treatment decisions for an individual patient.

At a population level, however, it deserves attention. ICSI is increasingly used beyond the severe male-factor infertility for which it was originally developed. When a technique is used at very large scale, even small population-level differences become worth understanding.”

Title: Intracytoplasmic sperm injection is associated with a shift in the human secondary sex ratio at birth.

Authors: Omar Ammar and Michael P. Rimmer.

You can read the Full Article in Scientific Reports.

Omar Ammar: Is ICSI Associated with a Change in the Sex Ratio at Birth?