Intracytoplasmic Sperm Injection ( ICSI )
Male infertility is present is up to half of infertile couples making it one of the most common causes of infertility. Given the percentage of couples with a male infertility component, the semen analysis must always be completed.
Before the advent of intracytoplasmic sperm injection (ICSI) combined with IVF, men with moderate to severe infertility had little, or no, chance of fathering genetically related children. The only option available was donor sperm.
Intracytoplasmic Sperm Injection (ICSI) revolutionized the treatment of male infertility, making it possible for men with few, and in some cases no, sperm in their ejaculate. ICSI enables up to 95 percent of couples to reach embryo transfer.
The main difficulty in treating male infertility used to be isolating adequate numbers of active sperm to combine with the eggs in the laboratory. Now with ICSI, very few sperm are required. Additionally, the ability of the sperm to penetrate the egg is not an issue since penetration is bypassed. Using ICSI, the sperm are injected directly into the egg.
Sperm can be isolated from the ejaculate even if the number present is extremely low. Sometimes there will be no sperm in the ejaculate and in these cases sperm can be withdrawn directly from the testicles (TESA) or the reproductive tract (MESA).
During the ICSI procedure, a high-powered microscope is used to enable the embryologist to perform precise surgical manipulations on the eggs and sperm. A tiny glass instrument called a micropipette is used to hold the eggs in place. The sperm is injected via a microneedle through the outer layers of the egg, past the shell, and into the main body of the egg. The sperm injection does not damage the embryo.
Men with the following abnormalities in their semen are candidates for ICSI:
ICSI is also used in couples where the female is “older”, when couples have failed previous IVF cycles because of failed fertilization, couples with unexplained infertility, and others. One additional advantage of the IVF/ICSI procedure is that it allows documentation of successful fertilization.
Studies of babies born after being conceived employing IVF/ICSI have not shown any increase in birth defects or other abnormalities.
To schedule a consultation or second opinion with Dr. Marwan Shaykh, contact the Assisted Fertility Program.