All About ICSI

If you are considering fertility treatment, you undoubtedly have been researching more than you ever imagined. Your partner, family or friends may teasingly refer to you as an “honorary doctor”. Rest assured, educating yourself prior to fertility treatment is the best thing that you can do for yourself!

The infertility literature is full of acronyms, and one that may be repeatedly popping up is ICSI.

What is ICSI?

ICSI stands for Intracytoplasmic Sperm Injection. Simply put, ICSI is a form of assisted reproductive technology where a tiny needle is used to inject a single healthy appearing sperm into a mature egg.

Conventional in vitro fertilization (IVF) and ICSI both require that the female partner undergo ovarian stimulation and subsequent egg retrieval. ICSI differs from conventional IVF in the method of fertilization. In conventional IVF, the egg and sperm are placed in a laboratory dish and left to fertilize. With ICSI, in contrast, a specific sperm is selected and directly injected into the egg. The technique involves the use of a high-powered microscope to select the sperm with the best “appearance” (morphology) with the goal of improving fertilization rate and overall outcome.

Do I Need ICSI?

Fertility clinics have increasingly used ICSI since the introduction of this technology in the early 1990s. ICSI is often determined to be necessary in cases of male factor infertility. If there is an abnormal semen analysis, ICSI will often be recommended. There are also other situations in which ICSI may be recommended. These include:

· Patients with unexplained infertility

· Patients with a history of poor fertilization with IVF

What Are the Risks?

During the fertilization process, there is a slight risk (less than 5%) that the egg can be damaged. Additionally, researchers have also determined that there is an increased risk of abnormalities in the X and Y sex chromosomes. At this time, the reason for this increased risk remains unknown.

There are often additional financial costs associated with ICSI. Many clinics charge an additional fee for the use of this technology.

How Successful is ICSI?

It is estimated that ICSI results in a fertilization rate between 50 and 80 percent. However, multiple factors, including the experience of the clinician, impact this rate. It is important to obtain this information from your specific clinic when making a decision.

Takeaway Message

ICSI is a technology that has been increasingly used by fertility clinics. ICSI is recommended in cases of male infertility. Additionally, ICSI may be utilized for couples with unexplained fertility or a history of fertilization issues with prior IVF cycles. The risks of ICSI include potential damage to the egg during the fertilization process and a slightly increased risk of abnormalities in the X and Y sex chromosomes. The success of ICSI ranges from 50 to 80 percent. Although some clinics now routinely add ICSI to all IVF cycles, it is important to discuss ICSI with your provider to see if this is a right choice for you.

Have you pursued ICSI? What were some of the reasons that ICSI was selected? We would love to hear from you. Please feel free to share your experience in the comments below.