Intracytoplasmic Sperm Injection (ICSI)
Used with IVF and eggs of good quality, ICSI often is a successful treatment for men with impaired or no sperm.
IVF ICSI has revolutionized the treatment of male infertility allowing fertilization to occur even if only a few sperma are available. First developed by reproductive medical specialists in Belgium, ICSI is a specialized form of microinsemination to help couples overcome male infertility problems such as: low sperm counts, poor motility or movement of the sperm, poor sperm quality, or sperm that lacks the ability to penetrate an egg. ICSI has become so successful that most treatments previously used for male infertility have been abandoned in its favor.
IHR's expertise in Intracytoplasmic Sperm Injection lies in our willingness and ability to individualize our approach to best suit each and every one of our patients. If you have any questions as you review the material on Intracytoplasmic Sperm Injection, please contact us for a FREE Intracytoplasmic Sperm Injection E-Mail Consultation..
During routine IVF, eggs and sperm are combined and incubated together in order to achieve fertilization. ICSI is performed by the embryologist, who surgically inserts one sperm into each egg. This is done by perforating the membrane of the egg with a glass pipette, which contains the sperm.
This procedure requires highly developed skills. Because only one sperm is needed per egg, even very small numbers of sperm can work. This becomes especially important in males with azoospermia (the complete lack of sperm present in the ejaculate). In such cases, we can offer a procedure called testicular sperm extraction (TESE), where our urologist extracts a small piece of testicular tissue that may contain sperm cells that can be used for ICSI. In a very high percentage of cases, azoospermic males can achieve fatherhood. Another surgical procedure may also be performed called Percutaneous Epididymal Surgical Aspiration (PESA)
Fertilization rates for ICSI: Most IVF programs see that about 70-85% of eggs injected using ICSI become fertilized. We call this the fertilization rate, which is different from the pregnancy success rate.
Pregnancy success rates for in vitro fertilization procedures with ICSI have been shown in some studies to be higher than for IVF without ICSI. This is because in many of the cases needing ICSI the female is relatively young and fertile (good egg quantity and quality) as compared to some of the women having IVF for other reasons.
In other words, the average egg quantity and quality tends to be better in ICSI cases (male factor cases) because it is less likely that there is a problem with the eggs - as compared to cases with unexplained infertility. Some unexplained cases have reduced egg quantity and/or quality - which lowers the chances for a successful IVF outcome.
IVF with ICSI success rates vary according to the specifics of the individual case, the ICSI technique used, the skill of the individual performing the procedure, the overall quality of the laboratory, the quality of the eggs, and the embryo transfer skills of the infertility specialist physician.
Sometimes IVF with ICSI is done for "egg factor" cases - low ovarian reserve situations. This is when there is either a low number, or low "quality"of eggs (or both). In such cases, ICSI fertilization and pregnancy success rates tend to be lower. This is because the main determinant of IVF success is the quality of the embryos. The quality of the eggs is a crucial factor determining quality and viability of embryos.
In some cases, assisted zona hatching is done on the embryos prior to transfer, in order to maximize chances for pregnancy.
Perhaps less known is our work with individuals and couples who are considering assisted reproduction, but who are uncertain of their next step. We encourage anyone, before they make a decision, to consult with us. Currently, we are offering a FREE ICSI E-Mail Consultation.