Intra-cytoplasmic Sperm Aspiration ( ICSI)

In the majority of cases of male infertility the sperm are not capable of penetrating the outer coating (zona pellucida) of the egg, and so fertility is not possible. The technique which is in clinical use now is Intra-cytoplasmic sperm injection (ICSI) where a single sperm is injected directly into the egg.

Which patients benefit from ICSI?

Patients with one of the following criteria are applicable for this treatment:

1. Previous failure of fertilisation or low incidence of fertilisation with conventional IVF.

2. An abnormal semen analysis with one or more of the following features:

• a count of less than 20 million per ml
• motility of less than 20% (asthenospermia)
• poor forward progression
• a high number of abnormal forms > 75% (teratospermia)
• the presence of antibodies

3. Small volume of semen specimen produced on the date of egg collection in combination with any of the above features and resulting in less than 0.2 x 10 of motile sperm (minimal number of sperm considered necessary for a routine IVF insemination).

Details of management of ICSI

The whole process of egg collection is followed as we have seen in the IVF section. The husband is asked to produce a semen sample on the day of the egg collection. This sample will be especially prepared and will only be used for micro-manipulation of the eggs using ICSI.

How is ICSI performed?

The mature egg is held with a specialized holding pipette.
A very delicate, sharp and hollow needle is used to immobilize and pick up a single sperm.
This needle is then carefully inserted through the zona (shell of egg) and in to the cytoplasm of the egg.
The sperm is injected in to the cytoplasm and the needle carefully removed.
The eggs are checked the next morning for evidence of normal fertilization.

Is the baby at any risk?

All parents face the risk that there may be something wrong with their child at birth – a congenital abnormality. The risk is around 2 to 2.5%. A number of research papers have suggested that the risk of having a congenital abnormality following ICSI is the same as occurs in in-vitro fertilization (IVF) and in the general population at large who are not infertile.

Also Read:
Ovulation Induction
Intra-Utreine Insemination (IUI)
In-vitro Fertilization ( IVF/ Test tube baby)
Intra-cytoplasmic Sperm Aspiration ( ICSI)
Percutaneous Epididymal Sperm Aspiration (PESA) / Testicular Sperm Aspiration (TESA)
Egg Donation / Sperm Donation/ Embryo Donation
Frozen Embryo Transfer