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Intracytoplasmic Sperm Injection, or ICSI, is a procedure used for some couples where there is a severe male factor or an abnormal semen analysis. It may also be useful for couples where standard IVF has led to poor or absent fertilization. Your physician will help decide if you are candidates for this procedure.
ICSI differs from standard IVF in several ways. After the woman has undergone egg retrieval, the eggs are carefully evaluated to determine their maturity status. Generally, 60-90% of retrieved eggs are mature in any given IVF cycle. The percentage of mature eggs is important since only the mature eggs are suitable for ICSI.
The sperm are prepared in the IVF laboratory in a slightly different manner for the ICSI procedure. This does not affect how the semen specimen is produced. The afternoon of the day of retrieval the eggs are placed under the microscope and a single is directly injected into an egg. All healthy mature eggs are similarly injected.
The day after retrieval, the eggs are evaluated for evidence of fertilization, just as in standard IVF. Typically, 50-80% of the mature eggs undergoing ICSI will fertilize. The remainder of the IVF process resembles that used in standard IVF with all changes taking place in the IVF laboratory.
Although most ICSI cases will be planned and discussed with the patient far in advance of the egg retrieval, there are times when the semen specimen produced at the time of egg collection is unexpectedly poor. In these cases, we may suggest that you switch from standard IVF to the ICSI procedure . We will do our best to guide you through the decision and provide you with a good understanding of the ICSI process. Most practitioners feel that there is no significant increase in serious birth defects with the ICSI process.
The decision to proceed with ICSI is one which should be discussed with your partner and physician. This will facilitate the coordination of your care with the IVF laboratory.
Overall, ICSI allows those couples with serious male factor infertility or failure to fertilize the eggs to increase their chance of becoming pregnant, usually comparable to other patients.
