Male subfertility is found in half of all infertile couples making it the single largest cause of infertility. Intracytoplasmic sperm injection (ICSI) provides hope to couples even when the male has moderate to severe infertility. In fact, pregnancy can be achieved with as few as one sperm. Your physician may recommend ICSI in the following situations:
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Moderate to severe male factor- in the past, donor semen or standard IVF were the only option for these couples. Unfortunately, fertilization of eggs did not often occur. Now, using ICSI, fertilization can occur with as few as one sperm.
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Unexplained infertility- a cause for infertility exists but cannot be discovered with today’s technologies.
- Failed fertilization- the eggs did not fertilize properly when exposed to sperm in a prior cycle.
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Advanced age and other couple specific situations.
ICSI is performed in conjunction with an
in vitro fertilization cycle. Once the eggs mature and are retrieved they are placed in special solutions and transferred to Petri dishes
(See the section on IVF for details).
ICSI is performed by our embryologist using a micromanipulator and microscopic tools. The egg is held in place with a holding pipette and one sperm is drawn into a microscopic needle. The needle punctures the egg membrane (zona pellucida) and the sperm is injected directly into the egg’s cytoplasm. This procedure does not damage the egg. This is similar to the process in nature where one sperm will attach to and penetrate each eggs cell membrane.
Sometimes a man will have very few or no sperm in his ejaculate. It is still possible to obtain viable sperm for ICSI using procedures such as microscopic epididymal sperm aspiration MESA and testicular sperm aspiration (TESA). MESA retrieves a single sperm from the male’s reproductive tract (the epididymis) and TESA retrieves sperm directly form the testes.
There has been some concern that ICSI may cause an eventual increase in conditions such as
male infertility. This is because in ICSI a sperm is “selected” by man rather than nature. Objective data to date has not demonstrated any increase in birth defects or other conditions such as male infertility.
ICSI provides a means for infertile couples to produce children genetically related to both parents.