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IntraCytoplasmic Sperm Injection (ICSI)  

In the history of fertility medicine, one of the most significant breakthroughs was the development of a process called intracytoplasmic sperm injection, or ICSI for short in 1990s. This technique was developed by G. Palermo at  Brussel .
If there is male factor infertility and the couple is going through in vitro fertilization (IVF), then ICSI is a better procedure.  It  has revolutionized the treatment of male infertility as it allows couples to achieve fertilization even when only a few sperm are available.
ICSI may be for you if the male partner has:

  • Antisperm antibodies
  • Severe male factor ( Retrograde ejaculation/Electroejaculation)
  • Had a vasectomy
  • Low or no motility
  • Abnormal morphology
  • Previous failed IVF cycles
  • IVF cycles with very low yield of eggs at the egg retrieval
  • Cryopreserved sperm
  • Sperms aspirated from testis ( TESA )

Many patients choose to undergo the ICSI procedure to maximize their success even when there is no clearly defined indication .

PROCEDURE :

  • The mature egg is held with a specialized holding pipette.
  • A very delicate, sharp and hollow needle is used to immobilize and pick up a single sperm.
  • This needle is then carefully inserted through the zona (shell of the egg) and in to the center (cytoplasm) of the egg.
  • The sperm is injected in the cytoplasm and the needle is removed.
  • The eggs are checked the next morning for evidence of normal fertilization

Fertilization rates of 70-80% (of all eggs injected) equivalent to that of fertilization with normal sperm are currently being achieved, and pregnancy rates are comparable to those seen with IVF in couples with no male factor infertility

  • 35 and younger: 45 percent
  • 35 to 37: 36 percent
  • 38 to 40: 25 percent
  • 41 to 42: 17 percent

There are some risks to using ICSI with IVF. For instance:
ICSI can damage healthy eggs during the process.
ICSI & IVF increases the risk of becoming pregnant with multiples.
Some theorize that there is a greater chance for genetic syndromes or birth defects following procedures like ICSI that manipulate sperm and eggs.However, this risk is minimal.