What is ICSI, and who is it suitable for?
ICSI (Intracytoplasmic Sperm Injection) is one of the many techniques that we can use to help couples who are finding it difficult to become pregnant. It is routinely offered to couples who do not have sufficient good quality sperm for regular IVF. It allows us to inject a sperm directly into an egg therefore increasing the chance of a successful fertilisation.
Fertilisation rates with conventional IVF may be reduced, or there may be no fertilisation at all, if:
- Sperm count is too low
- Sperm have low or slow motility
- Sperm have a very high proportion of abnormal shapes
- High levels of antisperm antibodies are present
Where surgically recovered sperm is used in cases of vasectomy, failed vasectomy reversal, obstructive azoospermia, or other causes, ICSI is necessary.
ICSI will also be offered to you if you have previously had failed fertilisation with standard IVF or if you have had poor fertilisation results in a previous cycle.
It is also offered in cases of unexplained infertility when we offer a 50:50 IVF:ICSI split just in case the problem turns out to be a fertilisation issue.
What happens during ICSI treatment?
From a patient’s point of view, ICSI is much the same as IVF. It is what happens in the laboratory that differs. After your eggs are retrieved your partner will produce a semen sample. Both your eggs and sperm are then specially prepared for ICSI.
Some hours after egg collection, each of your mature eggs (generally at least 80% of those collected) is injected with a single sperm under a high-powered microscope using a fine glass hollow needle. We try to use the best quality sperm; those that are seen to be motile and normal in shape.
After the ICSI procedure your injected eggs are placed in an incubator and inspected the next morning to see how many have fertilised. This is typically around 60% of those injected, similar to conventional IVF, although it varies from case to case. More than 95% of couples having ICSI can expect at least some of their eggs to be fertilised.
Following the fertilisation check, the early ICSI embryos are grown in the lab and used in exactly the same manner as those from IVF.
Surgical sperm retrieval
For some men with no sperm in the ejaculate it is necessary to perform a surgical sperm retrieval before the day of egg collection.
As ICSI is a delicate technique requiring specialist equipment and expertise and takes time, it costs more than straightforward IVF.
ICSI pregnancy rates are very similar to those achieved with conventional IVF.