Intracytoplasmic injection (ICSI) is a special form of IVF in which individual sperm are injected into the egg under microscopic vision. This is the treatment advised for couples where the sperm quantity or quality is very poor or when IVF has resulted in failed fertilisation. It is also used when the sperm has been collected through surgical sperm retrieval. Who needs ICSI?
Candidates for ICSI include men with (1) severely compromised sperm parameters, including concentration, motility, morphology, or antisperm antibodies; (2) blockage or absence of the vas deferens, where sperm is surgically collected by epididymal aspiration or testicular biopsy for ICSI;
(3) those who had low or failed fertilization on prior IVF attempts; and (4) unknown infertility (causes of couple’s infertility remain unknown after completing all diagnostic testing). The success rate with this technique varies considerably among IVF programs and is highly dependent upon the skill of the embryologist performing the procedure. One of the most important aspects of a successful IVF cycle is the handling of the eggs and embryos outside of the body. Among our standard protocols is the use of sequential media which is designed to physiologically resemble the environment in the female body. Reproducing the human environment aims to minimize the intracellular stress of the embryo, which is necessary for a positive treatment outcome. Specialized environmental conditions are maintained in the IVF laboratory to eliminate contaminants and volatile substances in the air which may adversely affect embryos.
ICSI is appropriate:
- When sperm is too poor for IVF such as; low count, poor movement (motility or progression) or high percentage of abnormal forms (morphology)
- When there are high levels of antisperm antibodies (e.g. following vasectomy reversal)
- When there has been previous failed or poor fertilisation during IVF
- When the sperm has been microsurgically recovered from the epididymis or testes
Men who have very few sperm (oligospermia), no sperm (azoospermia) or high numbers of abnormal sperm would previously have had little or no chance of fathering their own genetic offspring. ICSI offers such men and their partners real hope of having their own genetic child.