April is National Infertility Awareness Month
ICSI (Intracytoplasmic sperm injection) is an in vitro fertilization technique developed to improve the likelihood of fertilization for men with sperm abnormalities or prior history of fertilization failure using standard IVF. (see video below)
Under a powerful microscope, an embryologist uses a tiny needle to pick up a single sperm and inject it directly into the cytoplasm of the egg. ICSI helps couples with very low sperm counts or poor sperm quality to achieve fertilization and pregnancy rates equal to traditional IVF. Special types of urological procedures can help men to retrieve sperm in those individuals with very low or no sperm in their ejaculate. Those sperm can then be used to fertilize their partner's egg using the ICSI procedure.
ICSI: The Technique
The power of ICSI is that it only requires one sperm to be effective. ICSI is a simple and elegant way to transfer one sperm directly into one egg. Using a microscope to see the sperm, an embryologist gently draws one sperm into a pipette. The tip of the pipette is then guided into the waiting egg. The egg is held steady at the end of another glass pipette. Now, with sperm and egg ready, the elegance of ICSI is revealed. With a steady and measured forward motion, the sharpened tip of the sperm-containing pipette is inserted into the egg. Reversing the process that pulled the sperm into the pipette, the embryologist now ejects the sperm into the egg. And finally, the sharpened tip of the empty pipette is removed from the egg.
Does ICSI damage the egg?
Thousands of ICSI procedures have been done successfully resulting in healthy offspring. This is not surprising to embryologists for several reasons. First, the egg is many times larger than the pipette that is used to penetrate its surface. Second, the human egg is encased in a tough, elastic membrane that doesn't’t crack, shatter or crumble. And finally, and most importantly, Mother Nature lends a hand: the egg has the ability to rapidly repair the small hole in its membrane made by the pipette.
Are there any side effects?
Despite widespread use and acceptance, ICSI is a relatively new procedure. Children born as the result of ICSI are still very young and have not yet reached an age to reproduce. Currently there are no reports of increased birth defects or congenital abnormalities in babies born through ICSI. Experts agree that despite its apparent simplicity, ICSI bypasses an important natural barrier: the egg surface. This may permit the transfer of certain male infertility conditions that have a genetic basis. Where a genetic basis to male infertility is suspected or known, the couple may also find it helpful to speak with a genetic counselor before choosing to use ICSI.
Intracytoplasmic sperm injection (ICSI), a specialized form of microinsemination, was first developed by reproductive medical specialists in Belgium to help couples overcome male infertility problems associated with an inability of sperm to fertilize an egg. Since then, ICSI has been successfully used to treat male infertility and is helping more couples to realize their dream of having their own biological children.
The technique is no longer considered experimental. It has received an endorsement from the American Society for Reproductive Medicine and is among the routine services offered by fertility specialists at the Reproductive Science Center of New England.
Dr Samuel Pang, Medical Director at RSC New England, is a fertility doctor in Massachusetts. A Board Certified Reproductive Endocrinologist he provides fertility screening and infertility treatment at the Reproductive Science Center fertility clinics in Lexington, Milford and Worcester, Massachusetts. He is an expert in male factor infertility in addition to IVF using donor eggs and/or a gestational surrogate.
This information is provided for general education purposes and is not intended to take the place of a discussion with your physician. If you have questions about any aspect of your health, you are advised to speak with your physician.