What is ICSI?
ICSI involves the injection of a single sperm into the cytoplasm of a mature egg, called an oocyte. Female partners undergo ovarian stimulation with fertility medications to stimulate mature egg development. The eggs are aspirated and incubated in a lab with the semen sample. Directly injecting the sperm into the egg improves the likelihood of fertilization when sperm quality, number, or function is abnormal. Instead of needing a large amount of sperm for conception, ICSI reduces the number of sperm necessary for fertilization.
Who can benefit?
ICSI is a last-ditch effort for many couples suffering from male factor infertility. ICSI is also considered for cases other than male factor infertility. The treatment can be considered for several situations, including:
- Unexplained infertility
- Variable sperm counts
- Poor fertilization with IVF
Couples are opting for ICSI even when the procedure is not necessary due to ICSI’s success rate. Males who have had a vasectomy reversal should seriously consider ICSI to avoid sperm antibodies that can reduce fertilization.
ICSI can achieve up to 80% fertilization rates of all mature eggs injected, which rivals fertilization with healthy sperm. Couples who use IVF and ICSI are seeing comparable fertilization rates to couples with no male factor infertility.
How many eggs are injected in ICSI?
ICSI specialists will inject as many mature eggs as possible if requested. Immature eggs may be incubated, but the chance of fertilization is low. Couples can choose a split ICSI where the procedure is performed on a majority of mature eggs, and the remaining sperm are incubated.
ART options for male factor infertility
Male factor infertility can be treated with many assisted reproductive techniques besides IVF, depending on sperm quality, quantity, and motility. Intrauterine insemination (IUI) can improve sperm motility and concentration issues. Testicular extraction of sperm (TESE) is performed when semen lacks sperm. Couples should discuss ART options with a fertility specialist to determine the best course of action.
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