Intra-Cytoplasmic Sperm Insemination (ICSI)

This treatment is given for couples where there is a problem of male infertility. One such example is that of a low sperm count or oligospermia. Other candidates for this treatment include abnormally shaped sperm or problems with sperm mobility.

It can also help those men who have undergone an unsuccessful vasectomy reversal procedure.

Oligospermia is caused by a variety of factors and is usually classified in two ways:

  • Obstructive
  • Non-obstructive

The intra-cytoplasmic sperm injection (ICSI) is an assisted reproductive technique (ART) which offers your male partner the chance to be a father.

It is also an option if you have tried IVF treatment but with no success.

Success rates for ICSI

These tend to be lower than for IVF and are currently around 35%.

The ICSI procedure

This is a highly complex and skilled procedure which requires a great deal of precision.

Basically, it involves introducing a single sperm into the egg, with special instruments, in a laboratory environment. This results in fertilisation taking place outside of the body.

There are 4 steps to this procedure:

  • Step 1: Extracting the eggs and ovulation stimulation

    This starts with the women being given a course of fertility drugs to stimulate ovulation, regulate egg development and allow harvesting of eggs to take place.

    You will undergo a series of tests which include an ultrasound scan to check that your eggs are ready for extraction.

    A minor surgical procedure called laparoscopy is performed in which the specialist inserts a thin needle to remove a collection of eggs from the ovaries. This process is called aspiration which means using a fine needle to withdraw fluid from the body.

    These eggs are placed in a supportive material which aids with their development. Once an egg is fully developed it is ready for fertilisation.

  • Step 2: Sperm extraction

    This is the man’s role in the process. Sperm is obtained in the normal way via ejaculation which is suitable for those men with a low sperm count. But, men with another type of infertility problem may need to undergo a surgical procedure, for example, testicular sperm extraction (TESE).

    Sperm are obtained via the testes (sperm production) or the epydidimis (sperm storage). A micropipette (super slim needle) is used to access the sperm.

  • Step 3: Fertilisation

    The micropipette picks up a single sperm which is inserted into the centre of the egg (cytoplasm).

    It will be 1 to 6 days before fertilisation is confirmed.

  • Step 4: Transfer of the embryo

    Once fertilisation has taken place the embryo is transferred from the laboratory to the woman’s uterus. More than one embryo might be placed to increase the chance of a successful pregnancy.

Side effects of ICSI

This is an effective procedure but like any ART procedure is not without its risks. These include:

  • Injecting sperm too forcefully into the egg which then damages the ova.
  • Damage to the membranes which can lead to miscarriage.
  • Using a weaker sperm for the process which may fail to fertilise the egg.
  • The risk of passing on genetic defects or a chromosomal abnormality.

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