ICSI

Infertility Is A Couple's Problem

Infertility is a couple's problem rather than the fault of either man or woman. Today, more and more couples are willing to undergo the testing necessary to establish the problem source. They work together toward fertility and the happy outcome of a pregnancy and birth.

When a man is infertile due to low sperm count, lack or motility or abnormal sperm, or high levels of antibodies in the semen, then intracytoplasmic sperm injection (ICSI) may be an effective method of fertilization. ICSI is an in vitro fertilization procedure that is commonly used to overcome male infertility problems and may be used in cases where the sperm is unable to penetrate the egg.

The Difference Between Conventional IVF And ICSI

In standard in vitro fertilization, the eggs and sperm are mixed together in a dish, and the sperm fertilizes the egg in a "natural" fashion. In order for this process to occur, it is necessary that there are large numbers of normal sperm that are actively swimming. When the sperm are affected, this process is not viable. In such cases, ICSI may be the answer to a couple's fertility problems.

ICSI is done in a lab under a microscope using a number of different devices to accomplish the task of fertilizing the egg with the sperm. An oocyte (egg) is held stable with the use of a holding pipette and a single sperm is collected in a hollow glass micropipette. The glass micropipette is used then to pierce through the egg into the inner part, called the cytoplasm. The sperm is then released into the egg and after the procedure, the egg is placed into a cell culture and checked within 24 hours for signs of fertilization.

As with conventional IVF, the preparation for ICSI requires stimulation of the ovaries to encourage development and maturation of the eggs. Then the eggs are retrieved in order to be fertilized in the lab. An egg is fertilized and an embryo is cultured. The embryo is then transferred back into the uterus where it will hopefully implant and grow.

Potential Problems With ICSI

It has been suggested that birth defects are increased with IVF in general and with ICSI in particular. However, studies vary in their findings. In a summary position paper, the Practice Committee of the American Society of Reproductive Medicine has said it considers ICSI a safe and effective therapy for male factor infertility. However, there may be an increased risk of transmission of selected genetic abnormalities to children, either due to the procedure itself or through the increased risk of such abnormalities in parents undergoing ICSI.

Success of ICSI varies between patients, especially according to the woman's age. However, about 25 percent of patients will have a baby after one attempt at ICSI.