Intracytoplasmic sperm injection (ICSI) is a new procedure that allows couples with sperm problems to have IVF treatment. Developed in Belgium in 1992, ICSI is the process of injecting a single sperm into an egg. It is a remarkable procedure since it allows men with only very few sperm to have a chance of having their own children.
ICSI is recommended when there is severe male factor infertility, including low sperm concentration, poor motility, blockages in the male reproductive tract or where there is a desire to get pregnant after having had a vasectomy. It may also be advised when the female has a very low yield of eggs during egg retrieval so as to directly improve the chances of fertilisation by clinical intervention. Your Rawal fertility consultant may also recommend this enhanced procedure if a previous IVF treatment has resulted in a low fertilisation rate of eggs.
The woman will be required to undergo ovarian stimulation to prepare her eggs for collection as in a traditional IVF treatment plan. The sperm from the male partner will then be processed, washed and inspected in our laboratory to select only one sperm which will then be carefully injected into a retrieved egg. The aim is to inject the most normal looking sperm with good progressive movement into each mature egg. In cases of surgically retrieved sperm ICSI or IMSI may be recommended to achieve fertilization.
Our embryologists will closely monitor the fertilization procedure and the developing embryos in preparation for embryo transfer back into the woman’s uterus. Any surplus good quality embryos can be frozen for future use.
Fertilisation rates following ICSI/IMSI can be high, but unfortunately not all fertilised eggs will develop into healthy embryos. Depending on the woman’s age, some of the eggs may be abnormal and therefore fertilisation may result in an abnormal embryo. It is rare that any eggs, sperm or resultant embryos are damaged in the procedure although some of the eggs may be very fragile and may not be able to sustain the micromanipulation procedure leading to disintegration. The HFEA site also acknowledges that there may be a risk of long term health issues for children conceived using IVF with ICSI as the sperm used in the procedure may not have otherwise fertilized an egg naturally, although, as yet, there is no conclusive evidence.
It is important for you and your partner to discuss the ICSI risks and benefits with our Consultant as they can provide information that’s specific to your personal fertility history. By obtaining a better understanding of ICSI risks and how they may impact you and your family, can help you make an informed decision on whether or not to pursue this particular course of fertility treatment.