ICSI is the best option for couples whow have infertility due to a male factor. The procedure requires only one sperm, which is injected directly into the egg. The fertilised egg (embryo) is then transferred to the uterus (womb) of the female partner.
What causes of infertility can ICSI manage?
ICSI enables fertilisation for following causes of infertility:
- Male with very low or zero sperm count or production
- Sperm problems like poor morphology (abnormal shape) or poor motility (not moving normally)
- Failure of fertilisation or an unexpectedly low fertilisation rate in previous IVF
- Males with vasectomy
- Males who are unable to ejaculate sperm
- Bad quality of frozen sperm
- Erection or ejaculation problems due to spinal cord injuries or diabetes etc.
- Sperm unable to penetrate through the outer layer of egg or production of antisperm antibodies
How does ICSI work?
After completing all the consent formalities and basic screening, the real ICSI procedure involves the following:
As in standard IVF procedure, the female partner is carefully monitored through vaginal ultrasound scans and possibly blood tests for ovulation. Fertility drugs are given to stimulate ovaries to produce more eggs. Eggs are collected using IVF procedure.
Meanwhile the male partner either collects the sperm by ejaculating into a cup on the same day or doctor can extract sperm from him under local anaesthesia by any of the following procedures:
- Percutaneous epididymal sperm aspiration (PESA) to extract sperm from epididymis
- Testicular sperm aspiration (TESA) to extract sperm from testicle
- Testicular sperm extraction (TESE) or micro-TESE is the process of taking a biopsy of testicular tissue, which sometimes has sperm attached
Each egg is injected with a single sperm obtained from male partner or donor. The remaining procedure is same as IVF.
Finally, if fertilisation does take place, the embryos will be cultured in the laboratory for up to six days and then between one and three of the best-quality embryos will be transferred to the womb.
Advantages of ICSI
- Conception of genetic child when other options are closed
- Sperm can be extracted by ICSI for IVF treatment if the male partner is anxious or could not ejaculate on the day of egg collection
- Can result in pregnancy in cases of unexplained infertility
- No effect on the physical and mental development of the child born with ICSI technique
Success rates of ICSI
Age plays a major role in the success of any of the IVF procedures. The younger individuals usually have healthier eggs and higher chances of success.