AN OVERVIEW OF INTRACYTOPLASMIC SPERM INJECTION (ICSI)

The process of intracytoplasmic sperm injection (ICSI) is an effective laboratory procedure that was developed to assist infertile couples that are undergoing in vitro fertilization due to male factor infertility.  Prior to the development of microinjection techniques, couples in which the male partner had very abnormal semen parameters, donor sperm was often needed to conceive. The development of ICSI, used since approximately 1992, has allowed many infertile men to become genetic fathers that otherwise would not have been able to conceive with their partner.

ICSI is a procedure that involves the insertion of a single sperm directly into the cytoplasm or center of eggs using a custom-made needle and is carried out through the use of a high-powered operating microscope. The ICSI microscope allows the embryologist to operate with small instruments on the eggs and sperm.

While ICSI is not a perfect technique it does offer a higher degree of success than just placing the sperm near the egg in patients with severe male factor infertility.  Overall, the rate of successful fertilization is high with over 70% of good eggs fertilizing with the sperm injection procedure in most cases.   It is important to remember that only  “good” eggs that have completed the normal maturation process can undergo this procedure.

Indications for ICSI

There are a number of indications for the use of ICSI. These indications may include:

• Frozen sperm collected prior to cancer treatment that may be limited in function – quality and quantity
• Prior fertilization failure or poor fertilization with conventional insemination during IVF.
• Sperm that has been retrieved surgically from the testes or epididymis when there was a blockage, absence, or abnormality of the male reproductive system.
• The presence of antisperm antibodies (immune or protective proteins that may inhibit sperm function)
• Very low number of sperm or poor motility
• Failure to conceive with inseminations despite normal sperm parameters

A variety of sperm problems may account for male infertility. Sperm can be completely absent in the ejaculate (azoospermia) or present in low concentrations (oligospermia). They may have poor motility (asthenospermia) or an increased percentage of abnormal shapes and forms (teratospermia).

There may also be abnormalities in the series of steps required for fertilization, such as sperm binding to and penetrating the egg. Deficiencies in any of these aspects of sperm function can lead to lack of fertilization. ICSI can overcome these deficiencies and result in the same rate of fertilization seen with conventional fertilization techniques.

When you visit your Colorado fertility doctor she can determine if ICSI is the correct treatment for your infertility problems.