Category: Your Fertility
Posted 24 Apr 2017
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.
Usually in IVF treatment, sperm that is 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 normal IVF is not considered useful.
Reasons for ICSI
Intracytoplasmic sperm injection is most often used as a procedure for male infertility. Infertility is a shared problem between the husband and the wife. 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. In this case, the procedure is used to inject a single sperm directly into the egg in order to facilitate fertilisation.
Other reasons for ICSI includes reversing male vasectomy by extracting the sperm directly from the testicle. In rare cases, the infertility might be due to the outer lining of the egg being harder than normal, preventing healthy sperm from penetrating it and completing the fertilisation process. In these cases, ICSI is also used during IVF.
How does ICSI work?
For the wife, going through ICSI is no different from regular IVF (see ACRM’s explanation on the IVF treatment cycle
), aside from maybe receiving additional medication to help prepare the eggs. Sperm is collected on the same day of the procedure, either from a sperm sample provided by the husband or extracted directly from the testicle. The sperm is then examined and washed to remove unwanted mucus and separate poor quality sperm from healthy looking sperm. Using special equipment, the embryologist injects a single, healthy-looking sperm directly into the egg collected from the wife. As with conventional IVF procedures, ICSI is performed on multiple eggs using multiple sperm provided that there are enough viable eggs and sperm.
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 85%. It is also unusual for there to be no fertilisation during ICSI, unlike during IVF. This means that using ICSI can help prevent the loss of a whole IVF 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 IVF specialist who will assess your causes for infertility and discuss whether ICSI is necessary for you to get pregnant.