In Vitro Fertilization
ICSI
ICSI (intracytoplasmic sperm injection) is the technique of injecting a sperm directly into an egg to promote fertilization. This technique has revolutionized the treatment of male factor infertility.
Before ICSI men with very low sperm counts were poor candidates for in vitro fertilization. The sperm from these men frequently did not penetrate the egg and no embryos were formed.
Since the introduction of ICSI in 1991, couples with isolated male factor are now among the best prognosis couples we treat.
Since we can only inject eggs which are fully mature, not all eggs obtained from a woman will undergo ICSI. Of eggs injected, 70-80% will fertilize. Overall fertilization rates and pregnancy rates are slightly better than with the conventional insemination technique used in IVF.
However, ICSI adds cost and has a small increase risk of birth defects. (See IVF Basics; Risks to the Baby). For these reasons, ICSI is typically reserved for special situations:
Indications for ICSI include:
• Low sperm counts
• Low motility of sperm
• Abnormally shaped sperm
• Previous failed or low fertilization with IVF
• Eggs with a thick zona pellucida
• Few eggs retrieved
• Unexplained infertility with no history of prior fertilization