What is ICSI?
Intra-cytoplasmic sperm injection ( ICSI ) involves injecting a single sperm directly into an egg in order to fertilize it. The fertilized egg (embryo) is then transferred to the woman’s womb just like regular IVF.
When is ICSI Recommended?
ICSI is often recommended to Couples who have had poor or no fertilization during a standard IVF, as well as Couples where Male Partner has:
- a very low sperm count
- a high percentage of abnormally shaped sperm. This can result in poor motility, which means the sperm can’t swim well.
- had a vasectomy and sperm have been collected from the testicles or epididymis (sperm reservoir)
- the male partner does not ejaculate any sperm but sperm have been collected from the testicles
- the male partner has had problems obtaining an erection and ejaculating. This includes men with spinal cord injuries, diabetes and other disorders.
- a vasectomy reversal that was unsuccessful or resulted in a very low sperm count or very poor quality sperm
How is ICSI Procedure Performed?
ICSI is done as a part of IVF. Since ICSI is done in the lab, your IVF – ICSI treatment won’t seem much different than an IVF treatment without ICSI. However for the male partner, ‘how’ the sperms are extracted might be different.
For a female partner, the steps are similar to IVF Procedure.
Just like regular IVF, the Male partner will be asked to produce semen sample on the same day as the egg retrieval. The semen will be analyzed under microscope and usually the best sperm will be extracted. However if the semen analysis shows that the sample hardly has any viable sperms, the Male partner may have to undergo some procedures for extraction of sperms.
Depending on the cause of male infertility Sperms can be extracted/collected from:
- The epididymis (a narrow tube inside the scrotum, where sperm are stored and matured) using a type of fine syringe. This process is known as ‘percutaneous epididymal sperm aspiration’ or PESA.
- OR from the testicles, using a process known as ‘testicular sperm aspiration’ or TESA.
- OR from tiny quantities of testicular tissues which are removed after testicular biopsy. This procedure is called ‘testicular sperm extraction’ or TESE.
After retrieval of sperm,an embryologist will place the eggs in a special culture, and using a microscope and tiny needle, a single sperm will be injected into an egg. This will be done for each egg retrieved. This does not automatically mean that the egg is fertilized, but ICSI now gives an opportunity for that complex process to commence.
ICSI is not a guarantee that Fertilization will take place
Subsequently one to three of the best quality embryos are transferred to the womb just like a regular IVF Cycle.
What are the advantages of ICSI?
- As compared to IVF, ICSI has better fertilization rates. This allows for more embryo’s to be formed and therefore increases the chances of cryopreservation of embryo’s.
- ICSI may give you and your partner a chance of conceiving your genetic child when other options are closed to you.
- If your partner is too anxious to ejaculate on the day of egg collection for standard IVF, sperm can instead be extracted for ICSI. This is usually overcome by cryopreserving a semen sample before starting the IVF cycle.
- ICSI can also be used to help couples with unexplained infertility. As ICSI and IVF pregnancy rates are very similar and ICSI leaves little scope for the unknown.
What are the Risks or Side Effects?
All the risks and side effects associated with IVF are also associated with ICSI.
As ICSI is more invasive and requires more handling than standard IVF insemination techniques, there is a small chance (<1%) that the egg may be damaged during the procedure – resulting in a non-viable egg.
Thousands of children have been born around the world as a result of ICSI. Till date, there is no convincing evidence that the incidence of birth defects is any different with ICSI or IVF as compared to those children born to other parents of similar age and health.
What is the success Rate for ICSI?
Please note that IVF and intra-cytoplasmic sperm injection (ICSI) success rates are very similar and as such are no longer presented separately. Please refer to the IVF Success Rate Section.