Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic sperm Injection (ICSI) is used in conjunction with IVF and involves the insertion of a single sperm directly into an egg. ICSI was introduced in the 1990’s and is a major breakthrough for infertile couples with moderate to severe male factor infertility, infertility due to unexplained causes, failed fertilization, and other causes.
Medications are administered during an IVF cycle to stimulate the development of multiple eggs. Once the eggs mature, they are retrieved and prepared for fertilization. If the partner has sufficient sperm of good quality, he provides the sample by masturbation and the eggs and sperm are combined in a Petri dish. However, if the sperm are inadequate, egg penetration and fertilization may not occur and ICSI becomes necessary.
In ICSI, a single sperm is identified in the ejaculate and collected in a microscopic pipette. A micromanipulator is used to secure the egg while a small hole is punctured in the outer membrane. The sperm is then inserted insuring “mixing” of the parent’s genetic material.
Sometimes there is no sperm in the ejaculate due to conditions such as anatomical blockage. Techniques have been developed that allow the specialist to withdrawn sperm directly from the reproductive tract. Testicular sperm aspiration (TESA) is the withdrawal of sperm directly from the testicles and microsurgical epididymal sperm aspiration is collection of sperm from the epididymus. Before these techniques, a donor had to be used in cases of severe male factor infertility.
ICSI is a very delicate procedure and requires manual dexterity, coordination, and extensive training. Our embryologist David Wininger, Ph.D. has years of successful clinical experience and consistently produces high fertilization rates.
Once the sperm is inserted into the egg, the resultant embryo is transferred to an incubator where it develops from three to five days. The embryo is transferred to the uterus once it reaches maturity.