ICSI-IVF is a specialized form of in vitro fertilization that is used mostly commonly in cases of severe male infertility, after repeated failed fertilization attempts with conventional IVF, or after egg freezing (oocyte preservation).
During, In Vitro Fertilization (IVF), the eggs and the sperm(s) are placed together in a culture dish to fertilize naturally like they would within your body.
With ICSI, the embryologist selects a single “best” sperm to inject directly into each individual egg.
Some fertility centres advocate for ICSI for every IVF cycle while others recommend it for those with severe male infertility or other medically related issue..
In spite of this, ICSI-IVF has helped a lot of infertile couples conceive when they otherwise couldn’t have done so with their own eggs and sperm.
ICSI mostly recommended mostly when a man has:
- Very low sperm count (also known as oligospermia)
- Abnormally shaped sperm (also known as teratozoospermia)
- Poor sperm movement (also known as asthenozoospermia)
In the event that a man produces sperm but has none in his ejaculate, testicular sperm extraction TESE, may be used to recover the sperm. ICSI is necessary for retrieving sperm by TESE. In retrograde ejaculation, if the sperm are extracted from the man’s urine, ICSI is also utilized.
ICSI (Intracytoplasmic Sperm Injection) is commonly associated with severe male infertility, but it is also used in a variety of other situations, based on evidence-based indications. Here are some examples where ICSI may be recommended:
Male Factor Infertility with Moderate to Mild Issues: Even in cases where the male partner’s sperm count or motility isn’t extremely low but still suboptimal for IVF, ICSI can increase the chances of fertilization. This can include men with low sperm count (oligospermia), poor sperm motility (asthenozoospermia), or sperm with abnormal morphology (teratozoospermia).
Previous IVF Failure: Couples who have undergone multiple IVF cycles without successful fertilization may opt for ICSI. In cases where fertilization failure occurs, ICSI can ensure that the sperm is directly injected into the egg, bypassing any fertilization issues.
Sperm Retrieval from Non-Ejaculatory Sources: Men who cannot ejaculate sperm due to medical conditions (such as spinal cord injury or retrograde ejaculation) may have sperm retrieved through other means, such as from the testicles or epididymis (TESE or MESA). ICSI is used to fertilize the eggs in these cases because the sperm retrieved may be limited in quantity or motility.
Frozen sperm are being used: If the thawed sperm don’t appear especially active, ICSI-IVF may be recommended.
Genetic Disorders: In cases where there are known genetic issues, such as with male-factor infertility linked to specific genetic conditions like Y-chromosome micro deletions (which affect sperm production or quality), ICSI can help overcome fertilization challenges.
Assisted Reproductive Technology for Male Genetic Conditions: For couples with male genetic disorders like cystic fibrosis or inherited chromosomal abnormalities that affect sperm function, ICSI is sometimes used in combination with preimplantation genetic testing (PGT) to select embryos free of these genetic issues.
Fertility Preservation: When men undergo medical treatments that may affect sperm production (such as chemotherapy or radiation), sperm is often preserved for future use. Due to the potentially lower quality of preserved sperm, ICSI is used to ensure successful fertilization when the sperm count or motility is compromised.
HOW TO PREPARE FOR ICSI TREATMENT
ICSI is done as part of IVF, with IVF you are required to be administered ovarian stimulation medication, in order to facilitate many eggs to develop simultaneously for the purposes of the fertility treatment. Your doctor will monitor your progress with blood tests and ultrasounds.
Once you have grown good sized follicles ,you will have the egg retrieval ,where the eggs are removed from your ovaries with a specialized ,ultrasound guided needle.
Your partner will provide his sperm sample that same day unless you’re using a sperm donor or previously frozen sperm.
Once the eggs are retrieved, an embryologist will place the eggs in a special culture, and using a microscope and tiny needle, a single sperm will be injected into an egg. This will be done for each egg retrieved.
If fertilization takes place, and the embryos are healthy, an embryo or two will be transferred to your uterus, two to five days after the retrieval.
