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ICSI Fertility Treatment for Male Factor Infertility



ICSI Fertility Treatment for Male Factor Infertility

Assisted Reproduction Technologies (ART) 0

An Intracytoplasmic Sperm Injection (ICSI) is a form of In Vitro Fertilization (IVF) which is used to treat severe cases of male factor infertility. This procedure involves the injection of a single sperm directly into a mature egg, making it different from conventional IVF wherein fertilization takes place by placing many sperm near an egg in a dish.

When ICSI is Recommended

When there are very few sperm available, a clinic may suggest an ICSI procedure. It is usually recommended when:

  • There was a failure of fertilization or a low rate of fertilization during previous IVF procedures.
  • A male has an extremely low sperm count.
  • Miscellaneous issues with the sperm such as poor motility or poor morphology are identified.
  •  Frozen sperm of not optimum quality is being used in a treatment.
  • Sperm needs to be collected from the epididymis or testicles surgically in instances when a patient may have had a vasectomy.
  • Embryo testing is being used.
How ICSI Works

Before the ICSI treatment commences, the patient as well as their partner will have to sign several consent forms and their blood will have to be tested for hepatitis B & C, HIV, as well as human T cell lymphotropic virus (HTLV) I and II.

Then, through a standard IVF cycle, mature eggs need to be collected from the female partner. A lab prepares the male partner’s semen so as to isolate the healthy moving sperm. The eggs from the female are allowed to rest for about two or three hours after they have been collected and the cumulus, which is the tight outer coating of the egg is removed from each egg. Once that is done, the mature egg is ready to undergo ICSI.

Eggs that haven’t matured cannot be injected, but can be incubated for an additional six hours, following which a reassessment is done to gauge its level of maturity. If they have matured, they may be injected along with the other eggs.

The egg is held in place using a special instrument and a single sperm is picked up by a sharp, thin needle-like instrument. Using extreme precision, the needle is penetrated into the zona pellucid, which is the outer coating of the egg, and into the egg itself as well. The sperm is then injected into the egg slowly and the needle is carefully removed, leaving the sperm in the egg.

The eggs that have been injected are then placed overnight in an incubator and the next morning, are checked for fertilization. A further 24 hours later, it can be determined how many eggs have divided and gone on to form embryos. Not all the eggs are fertilized and not every fertilized egg turns into an embryo. The medical history and age of the female patient determines the number of embryos replaced into the uterus, much in the same manner as standard IVF procedures. The initial male semen analysis, diagnosis and age of the female determine the potential improvement in fertility with this treatment. These factors must be discussed with a fertility specialist.

Potential Risks of ICSI Fertility Treatment

ICSI fertility treatment is said to be a comparatively more invasive procedure and requires more handling as compared to standard IVF insemination techniques. The potential risks involved in this procedure are that there is a 2% chance that the egg may be damaged during the procedure, and therefore become a non-viable egg, which is not fit for fertilization.

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