Intracytoplasmic Sperm Injection (ICSI)
ICSI is an assisted reproductive technique whereby a sperm is injected directly into the outer wall of the eggs (cytoplasm).
1. Which patient is suitable for an ICSI?
- Couples with infertility due to male causes.
- Unexplained infertility.
- Couples who have failed several attempts of IVF.
2. What are the steps involved in ICSI?
- Drug treatment to stimulate the ovaries to produce multiple eggs.
- Monitoring of follicles either by ultrasound or hormones via blood test
- Eggs collection usually under local anaesthetic. This is usually done through the vagina. There is no incision on the abdomen.
- Sperm could be obtained the natural way or if the male partner has no sperm in the ejaculate (azoospermia), the sperm is retrieve by a simple procedure called percutaneous epididymal sperm aspiration (PESA) or Testicular sperm extraction (TESE).
- Fertilisation whereby a single sperm is directly injected into the egg. The next day, the eggs are examined under the microscope by the embryologist to see whether fertilization has occurred.
- Embryo transfer after two to three days later if the eggs have fertilized.
- Pregnancy testing
3. Is there any risk to the offspring produced by ICSI?
In some cases, male infertility could be associated with underlying abnormalities that could be inherited to their offspring. Chromosomal studies could be done if you want to before proceeding with ICSI. There have been many thousands of children born after IVF with ICSI. Follow up of the children after birth in the majority of the research has so far not showed an increased risk of abnormalities. Unfortunately, medical literature currently still could not provide us with a definitive answer. Further research and evaluation is ongoing.
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