What is ICSI?

ICSI or Intra-cytoplasmic sperm injection is a procedure done during the process of IVF (In Vitro Fertilization). In this process sperms are injected directly in the eggs to ensure fertilization. The method of intra-cytoplasmic injection of sperm (ICSI) is an elaborate micromanipulation technique when the sperm is aspirated in to a thin sharp glass capillary and inserted in to an egg through its shell.

Indication for ICSI is the inability of the sperm to fertilize the egg spontaneously (low count, low motility), immunological causes of infertility, failing of classical IVF cycles, later age, low number of matured eggs, when cryo-preserved sperm is used or when the sperm is collected by MESA/TESE method, when donor’s eggs are used etc. This method has a very high success rate of fertilization. The patient has to indeed undergo the normal procedure of super-ovulation and egg retrieval and the partner has to provide the sperm. In the view of collected data we can say that by fertilization of the egg using this method is not increased risk of a child with congenital developmental defect when compared to spontaneous conception.

Who should consider ICSI?

ICSI as a treatment method was first carried out in the year 1991 and since then has revolutionized IVF treatment and its success rates. The indications for ICSI include:

• Male factor infertility – In patients having any issues with number of sperms (oligospermia), motility of sperms (asthenospermia) or quality of sperms (teratatospermia), fertilization by using ICSI is indicated.

• Also, in patients with azoospermia in whom sperms are retrieved using surgical sperm retrieval techniques like PESA, TGSA, TESE, Micro-TESE will need ICSI.

• In patients with high sperm DNA fragmentation.

• In patients with unexplained infertility.

• In advanced age group patients.

• In patients whom in previous cycle, fertilization rate of eggs was low.

• Frozen eggs are being used for fertilization.

How successful is ICSI?

With ICSI, fertilization rates of mature eggs are in the range of 70-80%. However, ICSI as such does not increase success rate in an IVF cycle if done in an unindicated case. Its only when ICSI is used in the indications stated above that a better fertilization rate and better pregnancy rate is seen.

Will all of our eggs be injected?

All mature eggs or M 2 eggs will be injected in ICSI process to ensure fertilization. Immature eggs cannot be used for ICSI.

What are the risks associated with ICSI?

An ICSI cycle does not increase the risk of major birth defects as compared to naturally born babies. Babies born through the ICSI or Intracytoplasmic sperm injection are healthy. Problems that cause infertility may be genetic in a few cases. As an example, male children conceived with the use of ICSI may have the same infertility issues as their fathers.