In the traditional IVF procedure, the patient's eggs are combined with her partner's sperm in a laboratory and the resulting embryo is implanted into her uterus. If infertility is due to problems with the man's sperm, a sperm micromanipulation technique called intracytoplasmic sperm injection (ICSI) can be used.
Intracytoplasmic sperm injection is most often used for couples who have had trouble conceiving due to the male infertility factor. In cases where fertilization does not occur due to low sperm count, poor sperm motility (movement), or abnormally shaped sperm, ICSI fertility treatment increases the likelihood of a pregnancy. Couples who have tried and failed to become pregnant with the traditional IVF procedures and men who have had an unsuccessful vasectomy reversal may find success with ICSI.
The ICSI Procedure
During the ICSI procedure, the head of a single sperm is injected into the egg, eliminating the need of the sperm to penetrate the egg for fertilization.
Step 1: Ovulation Stimulation and Egg Retrieval
A full ICSI cycle includes a number of steps. First, the woman may be prescribed fertility drugs to help stimulate ovulation, control the egg ripening, and make it possible to collect multiple eggs. When it has been determined through ultrasound that the eggs are ready, they are retrieved in a minor surgical procedure in which a hollow needle is used to remove the eggs from the ovaries.
Step 2: Sperm Retrieval
For men with low sperm count or motility, sperm is obtained through normal ejaculation. For those with other fertility problems, surgical procedures such as microepididymal sperm aspiration (MESA), percutaneous epididymal sperm aspiration (PESA), or testicular sperm extraction (TESE) may be necessary to retrieve the sperm.
Step 3: Fertilization
Once the sperm and eggs have been retrieved, a single sperm is picked up with a very small needle which is inserted through the zona pellucida (the shell of the egg) and into its center (cytoplasm). The fertilization will be confirmed within about one to six days.
Step 4: Embryo Transfer
The resulting embryo or embryos are placed in the woman's uterus in a procedure called embryo transfer. Multiple embryos, typically between two and four, may be placed in the uterus to increase the probability of pregnancy.
A cycle of ICSI and IVF costs $10,000 or more, depending on where you live and what extra options are involved, and it may take more than one cycle to achieve a pregnancy. ICSI costs about $1200 to $1500 as a stand alone procedure.
Most studies show that there is no increase in birth defects and other
problems with babies born from an ART pregnancy than babies born by natural
methods. Regardless, concern still exists about the quality of the sperm used
in the ICSI procedure.
In natural conception, only the hardiest sperm are able to fertilize an egg, thereby weeding out lower-quality sperm. During the ICSI treatment, sperm is chosen and injected into the egg, allowing for the possibility that weaker sperm will be used. If severe male infertility is a factor, the concern is that the causes of the infertility may be passed on to children, along with other chromosomal abnormalities and genetic problems that are associated with infertility.
To determine the risk of passing these genetic problems to children, some specialists suggest that a couple undergo genetic screening before ART procedures such as ICSI.
Consult a Qualified Specialist
To learn more about ICSI, as well as its risks and benefits, consult a fertility doctor in your area through DocShop's online directory. A fertility specialist can answer any questions you have about treatment.