Womens Health


Intracytoplasmic sperm injection (ICSI) is a cutting-edge fertility treatment technique that helps men with low sperm counts to become fathers. This is because ICSI, used in conjunction with IVF treatment, involves injecting a sperm cell directly into an egg in a bid to have fertilization take place. The sperm can be carefully selected by the specialist performing the procedure in the laboratory. This means that a man with sperm quantity or quality problems can have his healthiest sperm cells selected for use in the procedure. If fertilization is successful, the resulting embryos are transferred into the female partner's uterus, just as they are in conventional IVF.

Who Else Can Benefit?

It's certainly not just couples suffering from male factor infertility who are granted access to ICSI. The criteria that couples have to meet vary from clinic to clinic. There are, however, some basic guidelines for situations in which ICSI is likely to be beneficial when used in combination with IVF:

- For couples in which the man has serious problems with the quality or quantity of his sperm, but the couple doesn't want to use a sperm donor as part of a conventional IVF procedure.

- For couples in which the man has low sperm concentration; poor sperm motility (ability of the sperm cells to swim and eventually penetrate an egg); or poor sperm morphology (abnormally shaped sperm cells that will have difficulty penetrating an egg and may contain DNA defects). These couples might have a chance of getting pregnant through conventional IVF - however, by supplementing the IVF procedure with ICSI, the chances of fertilization may be increase, not to mention the chances of fertilization by a healthy, high-quality sperm cell.

- For couples who have been through at least one IVF cycle of treatment before, and have a history of low fertilization rates following egg retrieval.

- For couples who find that after egg retrieval, they have a relatively low number of eggs available for fertilization. ICSI increases the chances that as many of these precious eggs as possible will be fertilized and transferred to the woman's uterus.

ICSI Procedure

The ICSI procedure is carried out after the early stages of IVF have been successfully implemented. The woman has been treated with ovulation-inducing drugs and her eggs have been harvested from her body. The eggs are now waiting in the clinic's laboratory for a specialist to inject the male partner's sperm cells into the female partner's eggs.

Once the sperm cells have been examined and the best ones have been selected for injection, ICSI can begin. The trained professional performing the procedure will use microscopes and micromanipulation instruments. He or she secures the egg and then uses a micropipette (a very thin, hollow needle) to pick up the relevant sperm cell, pierce through the outer shell of the egg, and inject the sperm cell directly into the cytoplasm inside. This sperm cell has been given a massive head start when comes to fertilization, which is why only one sperm cell is injected into each egg.

The next day, the eggs will be checked for signs of fertilization. If the procedure is successful, the resulting embryos are transferred into the woman's uterus as is normally done in IVF. Before this is done, assisted hatching of the embryos can be carried out. This increases the chances of implantation and pregnancy even further. Once transfer has taken place, the couple has to wait and hope, just as every IVF couple does.

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