ICSI – the answer to male fertility problems

It is very probable that when you decide to undergo In vitro fertilization it will turn out you will need some additional procedures. Depending on the nature of infertility and which of the partners – male or female (or both) suffer from it those procedures will be different. One of the most popular procedures done additionally to IVF is the Intra-cytoplasmic sperm injection (ICSI) which is very often done if the infertility is entirely or partly caused by the low sperm count or sperm’s mobility problems and morphology. The intra-cytoplasmic sperm injection was developed by Gianpiero Palermo from the Vrije Universiteit Brussel. First child born thanks to ICSI was born in Singapore in April 1989

What is Intra-cytoplasmic sperm injection (ICSI)?

Intra-cytoplasmic sperm injection (ICSI) is a method used in IVF which involves selecting a single sperm which is then injected directly to the egg. Therefore it is a great treatment in cases of male infertility when a man has very low sperm count. However not only, it can also be used in cases of other problems with sperm like poor morphology or if the sperm has very slow movement. Furthermore it is an option for men which had vasectomy or extremely low sperm count then the sperm can be surgically collected directly from the testicles. It can also be recommended if in past IVFs fertilization failure occurred.

Before doing ICSI

Before you are allowed to undergo ICSI you need to have blood tests to screen for HIV, hepatitis B and C, human T cell lymphotropic virus (HTLV) I and II. For a woman the procedures starts with stimulating the ovaries with drugs so they produce more eggs like in an IVF procedure. The whole progress is monitored by a vaginal ultrasound scans and sometimes blood tests. Next step is the egg collection, that is the similar step to expect during IVF treatment, and  fertilized egg is then placed in a woman’s uterus or fallopian tube.  Next steps are similar as during IVF procedure.

ICSI process

Your partner can provide a fresh semen sample at the day of collection or by doing percutaneous epididymal sperm aspiration (PESA) it involves using a syringe and collecting it directly from the epididymis.It can also be collected by testicular sperm aspiration (TESA), in this process the sperm is retrieved directly from the testicles.There is also the testicular sperm extraction (TESE) method which involves removing a tiny bit of testicular tissue and extracting sperm from it. After the sperm is collected a single sperm is injected into each egg. If everything goes all right fertilization occurs. Next the embryos all cultured in the laboratory. After a couple of days, maximum 6 days,  the best quality embryos are transferred into the womb.

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