Intra-cytoplasmic sperm injection (ICSI) differs from conventional in vitro fertilisation (IVF) in that the embryologist selects a single sperm to be injected directly into an egg, instead of fertilisation taking place in a dish where many sperm are placed near an egg.
ICSI treatment for whom?
ICSI enables fertilisation to happen when there are very few sperm available.
you have a very low sperm count
other problems with the sperm have been identified, such as poor morphology (abnormal shape) or poor motility (not moving normally)
during previous attempts at IVF there was failure of fertilisation or an unexpectedly low fertilisation rate
you need sperm to be collected surgically from the testicles or epididymis (a narrow tube inside the scrotum, where sperm are stored and matured); for example because you have had a vasectomy, you do not ejaculate sperm, or because you have extremely low sperm production
you are using frozen sperm in your treatment which is not of optimum quality
you are using embryo testing.
How is Semen retrieved for ICSI process ?
For men who have low sperm count or sperm with low mobility, the sperm may be collected through normal ejaculation. If the man has had a vasectomy, the microsurgical vasectomy reversal is the most cost-effective option for restoring fertility. Needle aspiration or microsurgical sperm retrieval are good alternatives when a competent microsurgical vasectomy reversal has failed, or when the man refuses surgery. Needle aspiration allows physicians to easily and quickly obtain adequate numbers of sperm for the ICSI procedure. A tiny needle is used to extract sperm directly from the testis.
Needle aspiration is a simple procedure performed under sedation with minimal discomfort; however, there is the potential for pain and swelling afterwards. The sperm obtained from testis is only appropriate for ICSI procedures when testicular sperm is not able to penetrate an egg by itself.
How is ICSI performed?
There are basically five simple steps to ICSI which include the following:
The mature egg is held with a specialized pipette.
A very delicate, sharp, and hollow needle is used to immobilize and pick up a single sperm.
The needle is then carefully inserted through the shell of the egg and into the cytoplasm of the egg.
The sperm is injected into the cytoplasm, and the needle is carefully removed.
The eggs are checked the following day for evidence of normal fertilization.
Once the steps of ICSI are complete and fertilization is successful, the embryo transfer procedure is used to physically place the embryo in the woman’s uterus. Then it is a matter of watching for early pregnancy symptoms. The fertility specialist may use a blood test or ultrasound to determine if implantation and pregnancy has occurred.