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Intra Cytoplasmic Sperm Injection (ICSI) is a laboratory procedure developed to help infertile couples

undergoing In Vitro Fertilization (IVF) due to severe male factor infertility. ICSI involves the insertion of a

single sperm directly into the cytoplasm of a mature egg (oocyte) using a special microinjection pipette

(glass needle). After sperm injection into the egg, further culture and embryo transfer is as with the IVF

cases. For patients with subfertile semen, this procedure is preferable to IVF. It was introduced in 1992

and was welcomed as a breakthrough in fertility treatment where the problem is on the mans

side.Since then ICSI has become the most successful technique in male infertility treatment.In ICSI only

one sperm is needed, which is injected directly into the egg. ICSI is now used in nearly half of all the IVF

treatments.

Fertility Tests for Men:

Although many people still think of fertility as a "woman's problem," up to half of all cases of infertility

involve problems with the man. In fact, about 20% to 30% of the time, a man's low fertility is the mainobstacle to conception. So it's crucial that men get tested for fertility as well as women. Yes, it can be

embarrassing, but discovering male fertility problems early can mean earlier treatment and a successful

pregnancy. Male infertility testing can also spare women unnecessary discomfort.

How to decide whether ICSI is for you?

If you have a low sperm count, low sperm motility or ability to swim, a damaged or missing vas deferens

which are the tubes that carry seminal fluid from the testes to the penis, or if you've had an irreversible

vasectomy, ICSI can help you impregnate your partner.

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How is Sperm collection done?

You'll provide a sperm sample. If there isn't enough sperm in your ejaculate, your doctor will remove

some from the passages that carry the sperm or from your testicle with a needle. If this doesn't work,

your doctor will take a biopsy of your testicular tissue, which may include sperm. Usually these

procedures are done under local anesthesia and the recovery isn't painful. It's also possible for the

sperm to be retrieved in advance and frozen until the eggs are ready for fertilization.

How the treatment is done?

Since ICSI is always used with in vitro fertilisation, the process starts with preparation for this procedure.

The woman is given fertility drugs to stimulate egg follicle development and ovulation. Her mature ova

are then retrieved to use during ICSI.

In additional preparation for ICSI, sperm is collected from the man. In cases where it is possible, sperm

can be collected from a semen sample. This is the preferred method since it is less invasive, but for some

men this may not be possible. An alternate option is to harvest the sperm directly from the man's

testicles using a testicular biopsy under anesthetic.

The single sperm is then injected directly into the woman's harvested egg with a very delicate needle.

The egg will reseal itself after the needle is withdrawn, just as it does in the process of natural

fertilisation when the sperm breaks through its outer membrane.

As in in vitro fertilisation without ICSI, the fertilised egg is then allowed to develop for a few days before

being transferred back into the woman's uterus in the form of an embryo. You can take a pregnancy test

about two weeks after the embryos are placed in the uterus.

ICSI is not a perfect technique. Some eggs will be damaged by the ICSI process. Some eggs have plasma

membranes that are difficult to pierce. In other instances, the fertilized egg may fail to divide, or the

embryo may arrest at an early stage of development.There is 34 percent chance of conceiving with the

help of ICSI, and a 28 percent chance of having a baby.

Perinatal outcome studies in Europe suggest that although multiple pregnancies are common with ICSI,

there is no evidence of increased incidence of congenital malformations or abnormal karyotype. There is

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no evidence that abnormalities may arise later in life to babies born as a result of ICSI, although there is

also no guarantee that all babies will be normal.

Couples who want to conceive using ICSI are still advised to analyze their family history for genetic

diseases and disorders and consult with a doctor. They may also want to consider pre-implantation

genetic diagnosis (PGD).

Length of the treatment

It takes about four to six weeks to complete one cycle of ICSI. You'll have to wait for your partner's

ovaries to respond to the medication and for her eggs to mature. You and your partner will spend a full

day at your doctor's office or clinic, having her eggs and your sperm retrieved. Your partner will have to

come back again to have the embryos inserted inside her uterus, but she'll be able to go home that

same day.

For more information on infertility treatment, Intracytoplasmic sperm injection treatment,

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