Intracytoplasmic Sperm Injection (ICSI)
This procedure is usually done in the cases of low sperm motility to produce healthy embryos which is then placed in the woman’s uterus
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Intracytoplasmic sperm injection (ICSI) treatment is an assisted reproductive technology (ART) used to treat sperm-related infertility problems. ICSI treatment is used to enhance the fertilization phase of in vitro fertilization (IVF) by injecting a single sperm into a mature egg. The fertilized egg is then placed in a woman’s uterus.
ICSI involves the egg being injected into the sperm, unlike conventional IVF where sperm and egg are put together in a dish and the sperm fertilizes the egg in a more natural way. Since the natural selection of sperm is not there in ICSI and the sperm is physically picked up the quality of sperm is important. As it is a microscopic procedure needing great precision and should be done quickly to avoid outside exposure of air for eggs which is detrimental to their growth, the expertise of the embryologist becomes important.
Indications of ICSI Treatment
- Severe male infertility ( Absent sperms/ poor count and motility): When little or no motile sperms are ejaculated in the semen they are unable swim up and fertilize the egg and can only fertilize an egg through ICSI, Similarly in men with absent sperms in ejaculate sperms are surgically extracted from testis by a needle or tissue biopsy and these sperm need an ICSI as they cannot move on their own.
- Some couples may choose to try ICSI after there has been a fertilization failure with conventional vitro fertilization i.e. sperm has been unable to penetrate the egg.
- ICSI is also used for couples who are planning to have genetic testing of the embryo to check for certain genetic disorders. ICSI uses only one sperm for each egg. So there is no chance the genetic test can be contaminated by another sperm or other cells around the egg.
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Frequently Asked Questions
When you decide to proceed with ICSI, we will make every effort to inject as many eggs as possible. It is important for you to understand that only eggs that are mature can be injected. We can easily tell if an egg is mature or immature. If an egg is not mature, we cannot inject it with sperm.
Generally speaking, the only situation where ICSI is considered absolutely necessary is in the case of male factor infertility with an abnormal semen analysis. Other reasons include previous poor fertilization with IVF, decreased number of eggs for fertilization, variable sperm counts, and unexplained infertility.
PESA and TESE procedures are the most popular because the goal is retrieval of sufficient sperm for freezing and use in future IVF cycles using ICSI.