What Is Intracytoplasmic Sperm Injection

Learn about ICSI, an advanced procedure in IVF fertility treatment

If you have been considering IVF treatment for your infertility problems, you may have heard of ICSI, or intracytoplasmic sperm injection. Find out more about what this procedure is and how it can be used to help improve your chances of getting pregnant.

In IVF treatment, sperm collected from the husband is mixed together with the egg to allow natural fertilisation. Intracytoplasmic sperm injection is an advanced IVF procedure where a single sperm is injected directly into the egg. This bypasses the natural “selection” process and increases the chances of fertilisation, especially when the sperm quality is compromised, sperm is retrieved directly from the testis or when poor fertilization was obtained in a previous IVF cycle attempt. 

Reasons for ICSI

Intracytoplasmic sperm injection is most often used as a procedure for male infertility. When there is a problem with the quantity or quality of the husband’s sperm, the concern is that the sperm may not be able to fertilise the egg normally even in the conventional IVF setting. There may be men with no sperm in the ejaculate, a condition called azoospermia. Sperm retrieved from the testis is used to inject a single sperm directly into the egg to facilitate fertilisation.

Other reasons for using ICSI includes reversing male vasectomy by extracting the sperm directly from the testicle. 

How does ICSI work?

For the wife, going through ICSI is no different from the normal IVF cycle. Sperm is collected on the same day of the procedure, either from a sperm sample provided by the husband, a frozen sperm sample or sperm extracted directly from the testicle. The sperm is then examined and processed to obtain good quality sperm.  Using special equipment called a micromanipulator, the embryologist injects a single, healthy-looking sperm directly into the mature egg. As with conventional IVF procedures, ICSI is performed on multiple eggs using a single sperm on each egg. 

Is ICSI more successful than normal IVF?

It is difficult to compare the success rates of ICSI to conventional IVF treatment, as it is often used specifically for male infertility problems while conventional IVF may be used when male infertility is not present. Many times, the wife’s egg is of good quality when the couple undergoes ICSI, increasing the fertilisation rate as opposed to infertility cases which are caused by woman’s age or poor egg quality.

Generally, studies have shown that ICSI has a good fertilisation rate of 70% to 80%. It is also unusual for there to be no fertilisation during ICSI, whereas there is a 5% chance that total failed fertilization may happen when performing IVF sperm insemination. Fertilization using the ICSI technique may help prevent failed fertilization and loss of the whole IVF treatment cycle.

Should you go for ICSI?

ICSI is currently the gold standard treatment when dealing with male infertility. In certain IVF centres, ICSI is a standard procedure during IVF.

While it has a good fertilisation rate, this should not be mistaken as a high pregnancy rate. The wife’s egg quality can affect the successful pregnancy rate despite a good fertilisation rate. You should consult an experienced fertility specialist who will assess the causes for infertility and discuss whether ICSI is necessary for you to maximise your chance of bringing home a baby.