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Intracytoplasmic Sperm Injection
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Intracytoplasmic sperm injection (ICSI) is an effective method to get eggs fertilized in the IVF lab and is mainly used to treat sperm-related infertility problems (male factor infertility). In ICSI, a single sperm is directly injected into an egg using micromanipulation. The procedure is done under a microscope using micromanipulation devices like microinjectors and micropipettes. A single sperm is injected directly into the cytoplasm of a mature egg (oocyte) using a glass needle (pipette). |
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| Who should opt for ICSI |
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ICSI is generally employed in the event of the following indications: |
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 Very low numbers of motile sperm
Severe Teratospermia (increased percentage of abnormal sperm shapes)
Problems with sperm binding to and/or penetrating the egg
Antisperm antibodies thought to be the cause of infertility
Prior or repeated fertilization failure with standard IVF methods
Frozen sperm limited in number and quality |
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Irreparable obstruction of the male reproductive tract. In such cases, sperm is obtained from the epididymis by a procedure |
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called microsurgical epididymal sperm aspiration (MESA), or from the testes by testicular sperm aspiration (TESA). |
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Success Rates |
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Fertilization occurs in 50% to 80% of injected eggs. Of all the ICSI cycles performed in the United States in 2002, 28% to 30% resulted in a live birth, which is comparable to rates seen with traditional IVF. Younger patients may achieve even more favorable results. |
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Concerns |
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The ICSI process may damage a small percentage of eggs. The fertilized egg may fail to divide, or the embryo may arrest at an early stage of development. Factors such as poor egg quality and advanced maternal age may result in lower rates of success.
ICSI does not increase the incidence of multiple gestation as compared to standard IVF. ICSI was first performed in 1992, and is thus considered a relatively new technique. As such, long-term data concerning future health and fertility of children conceived with ICSI is not available. There have been reports of an increase in the incidence of a congenital malformation called hypospadias (urethra opening on underside of penis) in babies conceived through ICSI. This is an area of ongoing investigation. Because some causes of male infertility are familial and are related to genetic problems, male offspring might have reproductive problems as adults. ICSI is generally unsuccessful when used to treat fertilization failures that are primarily due to poor egg quality |
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Conclusion |
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Despite concerns, ICSI is a major advance in the treatment of severe male infertility. It increases the likelihood of fertilization when there are abnormalities in the number, quality, or function of the sperm. The significance of ICSI is clear when you consider the fact there is still no medication available to cure infertility. |
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