Intracytoplasmic Sperm Injection (ICSI) is a specialised form of In Vitro Fertilisation (IVF) that is used for the treatment of severe cases of male factor infertility. ICSI involves the injection of a single sperm directly into a mature egg.The fertilized egg is then placed in a woman's uterus or fallopian tube.ICSI is an ART technique used to treat sperm-related infertility problems. ICSI is used to enhance the fertilization phase of IVF.
If sperm cannot be collected by means of masturbation, they are surgically removed from a testicle through a small incision. This method of sperm retrieval is done when there is a blockage that prevents sperm from being ejaculated or when there is a problem with sperm development. To screen for possible genetic problems that could affect offspring, experts recommend that men with little or no sperm in their semen (not due to a blockage) have genetic testing before they proceed with ICSI.
Ovulation and egg retrieval
To prepare for an assisted reproductive procedure using your own eggs, you must get daily injections and be closely monitored for 2 weeks before egg retrieval. At home, you or your partner injects you with gonadotropin or follicle-stimulating hormone (FSH) to stimulate your ovaries to produce multiple eggs (superovulation). After the first week, your doctor checks your bloodestrogen levels and uses ultrasound to see whether eggs are maturing in the follicles. During the second week, your dosage may change based on test results and ultrasound. If follicles fully develop, you are given a human chorionic gonadotropin (hCG) injection to stimulate the follicles to mature. The mature eggs are collected 34 to 36 hours later using laparoscopy or needle aspiration guided by ultrasound through the abdomen to the ovaries.
Sperm injection and transfer
Under high-power magnification, a glass tool (holding pipet) is used to hold an egg in place. A microscopic glass tube containing sperm (injection pipet) is used to penetrate and deposit one sperm into the egg. After culturing in the laboratory overnight, eggs are checked for evidence of fertilization. After incubation, the eggs that have been successfully fertilized (zygotes) or have had 3 to 5 days to further develop (zygotes or blastocysts) are selected. Two to four are placed in the uterus using a thin flexible tube (catheter) that is inserted through the cervix. The remaining embryos may be frozen (cryopreserved) for future attempts.
The ICSI procedure can help you and your partner get pregnant despite certain male infertility problems, like the following:
Sperm unable to penetrate or fertilize an egg
Low sperm count or poor sperm quality
A blockage or anatomical abnormality in the male's reproductive tract that prevents him from producing or ejaculating sperm
Men who require a testicular or epididymal biopsy in order to conceive (such as after a vasectomy)
Couples who did not have a successful fertilization in a previous IVF cycle
Success rates of ICSI :
The vast majority of couples dealing with male factor infertility used ICSI with their IVF cycles. Here are some IVF success rates per fresh embryo transfer from couples diagnosed with male factor infertility. Remember, most of these couples choose ICSI along with IVF.
» Women 35 and younger: 48.3 percent gave birth
» Women 35 to 37: 42 percent
» Women 38 to 40: 29.8 percent
» Women 41 to 42: 20.4 percent
» Women over 42: 7 percent
Some risks of ICSI :
There are some risks to using ICSI with IVF. For instance:
» ICSI can damage healthy eggs during the process.
» IVF (with or without ICSI) increases the risk of becoming pregnant with multiples. Couples that use IVF have a 30 to 35 percent risk of having twins and a 5 to 10 percent risk for triplets or more.
» Some theorize that there is a greater chance for genetic syndromes or birth defects following procedures like ICSI that manipulate sperm and eggs. Some studies suggest evidence of an increased incidence of certain birth defects. However, this risk is minimal. Unfortunately, since ICSI is a relatively new procedure, there is little known about the long-term side effects of the treatment.
Yes, there are some risks to ICSI, but there are also many benefits to using ICSI. If your partner has male factor infertility, ICSI with IVF to help you get pregnant.