An in vitro fertilization procedure involving the injection of one sperm cell into the egg’s cytoplasm, intracytoplasmic sperm injection (ICSI), is meant to prepare sperm and ova (gametes) for development of embryos, that can then be transferred to the uterus.
Although ICSI seems similar to traditional IVF, only the steps taken before and after completion of the procedure are the same. While IVF requires hundreds and thousands of sperm cells per egg, ICSI needs just one sperm cell for each egg. Individual sperm used during an ICSI procedure are selected by licensed embryologists.
Timeline History of Intracytoplasmic Sperm Injection
1990–ICSI is developed at the Vrije University in Brussels by Dr. Gianpiero Palermo
1990–Activated embryo produced by ICSI (embryo developed but was not transferred)
1991–Palermo accomplishes the first pregnancy using ICSI
1992–First successful ICSI birth happens in January
1993 to present–ICSI techniques continue to be perfected and utilized when sperm deficiencies are discovered to be the primary factor interfering with a couple’s ability to conceive.
ICSI and Male Infertility
Intracytoplasmic sperm injection may be recommended when men have poor or declining sperm quality, reduced sperm motility, or sperm that are too weak to penetrate the woman’s egg.
Another cause of male infertility that could benefit from ICSI is azoospermia, or lack of sperm in an ejaculation. Obstructive azoospermia may occur if a man has had a previous vasectomy, was born without a vas deferens (duct conveying sperm to the urethra), or suffered infections that lead to scarring.
Non-obstructive azoospermia is more commonly diagnosed than obstructive azoospermia and involves one or both testicles not producing any sperm. In cases of non-obstructive azoospermia, the chance that doctors can obtain viable sperm is low. When an ICSI procedure fails to produce a pregnancy in cases of non-obstructive azoospermia, donor sperm is a possibility couples may consider to get pregnant.
How Is ICSI Performed?
The intracytoplasmic sperm injection procedure consists of five basic steps:
- A mature egg is removed from the woman and held temporarily in a pipette
- Doctors use a hollow, very thin needle to immobilize and retrieve one sperm cell
- This needle is inserted gently through the egg’s outer shell and into the egg’s cytoplasm
- A single sperm is then injected into the egg’s cytoplasm
- Within 24 hours, eggs are evaluated for signs of fertilization
If fertilization occurs, the embryo is transferred to the uterus. Within a few weeks, blood tests and ultrasounds are used to determine if the woman is pregnant.
Retrieval of Sperm Using ICSI
Men with low sperm motility or low sperm count may be able to provide sperm through ejaculation, depending on the severity of motility or count issues. If normal ejaculation does not contain viable sperm, needle aspiration (percutaneous epididymal sperm aspiration) may be necessary to obtain sperm for an ICSI procedure. Sperm samples are collected on the same day eggs are retrieved. Unwashed or washed sperm can be used for ICSI.
ICSI for Women with Infertility Problems
ICSI is also an effective assisted reproductive technology treatment for women having trouble getting pregnant. If a previous in vitro fertilization cycle indicated you had insufficient fertilized eggs, ICSI may be recommended. Other reasons for choosing ICSI include:
- When frozen instead of fresh sperm is used. In some cases, the motility of thawed sperm is reduced
- When frozen eggs are used. Freezing (vitrification) of a woman’s eggs may harden the outer shell of an egg
- When a pre-implantation genetic diagnosis is performed. PGD screens embryos for genetic disorders. There may be a concern that using standard IVF or IUI techniques may compel sperm cells that have not fertilized an egg to remain around the embryo. This can negatively impact the results of a PGD
Seeing A Professional for ICSI
Viera Fertility Clinic has helped many couples overcome infertility by using state-of-the-art assisted reproductive technology procedures, such as intracytoplasmic sperm injection.
Viera Fertility Clinic offers male fertility testing in Melbourne. Contact us today to schedule an appointment and start your dream family you’ve always dreamed of!