ICSI treatment, also known as Intracytoplasmic Sperm Injection,
is when one sperm is microinjected into an egg for fertilisation.
ICSI: What is it?
ICSI vs IVF?
Why ICSI could be an option
If your infertility is related to low sperm count or motility, or there are other limitations to the fertilisation process such as sperm antibodies or previous failure to fertilise through IVF, your fertility specialist might recommend ICSI as a treatment.
In IVF each egg is surrounded by approximately 100,000 sperm, and fertilisation happens according to ‘survival of the fittest’. ICSI treatment, however, is where a single ideal-looking motile sperm is selected and injected into the egg under microscopic guidance. Following this, fertilisation and embryo development occur.
From here, the ICSI journey is similar to the IVF process
ICSI can be the recommended avenue for specific situations:
- When the man’s sperm count is meagre or at a zero sperm count
- If the sperm has low motility or high abnormalities
- Your partner has sperm that can’t be ejaculated but can be collected from the testicles or from the epididymis (if your partner has had an irreversible vasectomy or injury)
- Your partner has trouble getting an erection and ejaculating (for example due to spinal cord injuries or diabetes)
- When a conventional IVF cycle resulted in a fertilisation failure
- ICSI is also used with preimplantation genetic screening and diagnosis
Once the egg has been fertilised, the resulting embryo is left to develop in an incubator over the next week before being transferred back to your womb.
How is the best sperm chosen for ICSI?
Sperm selection for ICSI is crucial as the healthiest sperm cells tend to be a particular shape and size, that is, particularly an oval head and a long tail which they use to push themselves along as they swim.
We next have to consider the motility of the sperm – sperm cell motility is its ability to move around and penetrate an egg. Abnormalities such as tails which are curly or doubled up aren’t sufficient enough when it comes to swimming.
In the case of ICSI, a small amount of washed and prepared sperm is placed in a thick, viscous material that slows the sperm down so that they can be selected according to their shape and motility.
The most “normal” looking and vigorous sperm is selected and then immobilised by squashing their tails with a glass injection needle. One of these sperms are captured into the needle tail-first, they are ready to be injected.
Are there any risks with the ICSI treatment?
As ICSI is a more intrusive procedure and requires more careful handling than standard IVF process, there is a small chance – less than two percent – that the egg may be damaged during the procedure, which would result in a non-viable egg.
Dr Tamara Hunter
Dr Tamara Hunter is the only female Certified Specialist in Reproductive Endocrinology and Infertility (CREI) in Perth. “My role is to help you identifying the problem, and choosing the right treatment with you and your family. In the Fertility area I help with identifying the causes why you’re not falling pregnant, or assist with sperm, egg or embryo preservation.”
Fertility specialists can use techniques such as pre-implantation genetic testing to ensure the best embryos are used in your IVF journey.
IVF treatment is a process where eggs are removed from your ovaries and mixed with sperm in a laboratory culture dish. In this process, fertilisation happens naturally.
Your IVF Journey
IVF isn’t something that can be done quickly. Read more about the journey when you consider IVF treatment.
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