Intra-Cytoplasmic Sperm Injection (ICSI)
ICSI is a specialized form of IVF that is mainly used when the male partner has significant male infertility issues, like poor sperm quality or morphology, or no sperm.
ICSI is a method to ensure that the egg is fertilized. In conventional IVF the eggs and sperm are mixed together in the lab and the actively swimming normal sperm swims towards the egg and fertilizes it. With ICSI they inject one sperm directly into the oocyte. According to the NHS over 5000 babies are born in the UK each year as a result of ICSI.
It was initially introduced by the IVF team working at the Brussels Free University in Belgium. At that time, assisted fertilization was being attempted through insertion of the sperm under the eggshell. The Belgian group took the extra step of injecting the sperm not only under the eggshell but actually into the middle of the egg itself. The first ICSI pregnancies were reported in 1992. Since then, tens of thousands of children have been born as a result of this unique procedure.
This treatment usually requires for the women to take fertility drugs in order to stimulate her ovaries to produce more eggs. A sperm sample is taken from the male partner's semen or surgically extracted from his testes or epididymis. Then, the eggs are surgically extracted from the woman's ovaries. Using a tiny hollow needle, one sperm is carefully injected into an egg. After injection, the fertilized egg is observed for growth and development. Once normal growth is observed, the embryo will be implanted back into the uterus where it has a chance to implant and grow.
This method is recommended for couples that are dealing with severe male infertility or couples that have tried IVF without success. If the male partner has zero sperm count, the chances of retrieving sperm surgically by PESA, TESA or TESE may be very low. We always have the option of surgical retrieval and if we may not be able to retrieve any, there's also the option of donor insemination (DI) or IVF with donor sperm. It’s also used for treating unexplained infertility in women or in women who are unable to produce a large number of healthy eggs.
If the male partner has had a vasectomy, the ICSI procedure may help the couple conceive. This may be especially helpful if the partner tried to have a vasectomy reversal that was unsuccessful, or if he doesn't want to have the vasectomy reversed
Success rates are equivalent to standard IVF and with both procedures the likelihood of a successful outcome is influenced with age.