Intracytoplasmic Sperm Injection (ICSI)
ICSI, or micro-insemination, is a method that we can use in the laboratory in connection with IVF treatment. We use this method when:
- There are few sperm cells in the man's ejaculate
- The sperm cells have poor motility
- In connection with Testicular Sperm Aspiration (TESA), whereby sperm cells are extracted through the scrotum
- Multiple IVF attempts have been made without pregnancy
The treatment you will undergo is the same as a normal course of IVF: hormone stimulation, egg extraction and implantation of the embryo.
ICSI – WHEN THE SPERM CELLS ARE IN NEED OF HELP
We recommend ICSI when the sperm cells are in need of a little extra help to fertilise the egg.
Depending on your fertility history, we might discuss ICSI with you right from our very first meeting in the case we consider that it will increase your chances of pregnancy. Our assessment will be based on sperm samples and a consideration of what treatment types you have tried already.
On some occasions we might discuss ICSI with you on the day you come in for egg extraction. Our embryologists will evaluate the sperm by microscope on the same day that your eggs are extracted. If the embryologists believe that ICSI may increase your chances of fertilisation, then we will talk to you about this possibility.
We can also choose to use ICSI on half of the eggs and regular IVF on the other half. This is usually something we opt for after you have already undergone several IVF attempts without pregnancy. There is not always a good explanation as to why pregnancy does not occur following fertility treatment, and so using ICSI on some but not all of the eggs can therefore help us to identify what approach is best in order to optimise the chances of pregnancy in your specific case.
ICSI IN THE LABORATORY
A normal sperm sample can contain several million sperm cells, but only one single sperm cell will be used to fertilise an egg. Normal sperm cells have good motility and are geared towards reaching the egg. If we examine a sperm sample and see that there are very few sperm or that the sperm do not move as normal, then this tells us that the chances of fertilisation are lower and we will therefore recommend ICSI – micro-insemination.
ICSI is performed in the laboratory once the eggs have been removed. The embryologist works using a special ICSI microscope in which both egg and sperm cells can be seen simultaneously.
The embryologist chooses the single sperm cell that looks most normal and moves as it should and injects it into an egg cell using a very thin glass pipette that is finer than a strand of hair. This method helps the sperm cells to fertilise the eggs.
The fertilised eggs, now known as embryos, are placed in an incubator and their development is carefully followed and monitored by the embryologists.
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