Intracytoplasmic Sperm Injection
 

ICSI, pronounced ick-see, is an acronym for intracytoplasmic sperm injection. In regular IVF treatment,an egg is placed in a petri dish, along with lots of sperm, in hopes that one of the sperm will fertilize the egg on its own.With ICSI, an individual sperm is injected directly into an egg using a specialized needle.ICSI may be used in severe cases of male infertility, like when the sperm shape is impaired (aka abnormal sperm morphology) or in cases of very low sperm count.ICSI must be used if testicular sperm extraction is used.

 Doctor's has been performing ICSI since 1997 and after hundreds of cycles have achieved success rates comparable to the best in the world.
Doctors's generally recommends ICSI for all patients where there may be some doubt as to the viability of their sperm.

ICSI is indicated for Men with sperm problems such as: 
     - low sperm count 
     - poor sperm motility 
     - high percentage of abnormal sperm 
     - men with sperm anti-bodies. 
     - retrograde ejaculation (ejaculation of the sperm into the urinary bladder) 
     - where IVF has been previously unsuccessful.

 
What is IVF with ICSI ?
 

Intracytoplasmic sperm injection, or ICSI, was developed to treat couples who previously had a very poor probability of achieving fertilization due to the male partner's extremely low numbers of viable sperm. 

This treatment,when combined with in vitro fertilization,allows these couples a more favorable probability of achieving conception. 
ICSI has replaced the two previously developed micromanipulation techniques of partial zona dissection, or PZD, and subzonal insertion, or SUZI, because of the overall higher fertilization rates achieved with ICSI. ICSI has revolutionized treatment for severe male factor infertility because the procedure requires only one healthy sperm to potentially achieve fertilization.

A variety of sperm problems can account for male infertility.Sperm can be completely absent in the ejaculate, a condition known as azoospermia. 
Men with low concentrations of sperm in the ejaculate have a condition known as oligospermia.Poor motility,or a condition called asthenospermia, occurs when the sperm do not have the forward swimming motion sufficient to make the journey from the ejaculation site in the female's vagina, though the reproductive tract, to unite with the egg in the fallopian tube. 

Men whose sperm have an increased percentage of abnormal shapes and forms have a diagnosis of teratospermia. 
Other sperm problems that prevent fertilization are abnormalities in the series of steps required for fertilization, such as the sperm's ability to bind and penetrate the cytoplasm of the egg. Male factor infertility may be caused by blockages, varicoceles, or abnormalities of the ejaculatory ducts causing low or no sperm in the ejaculate. 

Men who have had a severe injury to their male reproductive organs, some neurological disorders, or surgery (including vasectomy), may have an absence of sperm in the ejaculate. 

Men who have had radiation and chemotherapy treatments for cancer, may have low or no sperm present in the ejaculate. 
Men who have provided semen samples prior to undergoing cancer treatments and major surgeries of their reproductive organs are candidates for ICSI due to the limited number of sperm available to achieve conception with ART procedures. ICSI may be a recommended treatment option for all of these infertile men.   

Fertility clinics often use intracytoplasmic sperm injection( ICSI ) to successfully fertilize eggs during in vitro fertilization treatment.ICSI removes any element of chance from the fertilization process by injecting sperm into the center of the egg.As IVF with ICSI requires only one healthy sperm to fertilize ova, fertility doctors recommend ICSI to couples where male factor infertility is a problem.

 

Step By Step
 

Step One: Ovulation Stimulation and Monitoring
The same process used in the other ART procedures to induce ovulation is used with ICSI. 

Step Two: Sperm Extraction
Semen samples can be obtained through masturbation. If any viable sperm can be obtained from this type of semen sample, procedures to extract sperm will not be used. The sperm sample will be evaluated and processed to select only the healthy, viable sperm for the fertilization procedure.When there is an absence of sperm in the ejaculate, surgical extraction procedures are performed.

One procedure called microsurgical epididymal sperm aspiration, or MESA, is used when sperm are unable to move through the genital tract due to uncorrectable blockage,congenital absence of the vas deferens or seminal vesicles. Aspiration is accomplished with MESA, usually performed as an outpatient procedure, when sperm are extracted directly from the epididymis. Epididymal sperm are typically not fully motile, which means they cannot swim through the female tract to reach the egg for fertilization. These sperm do contain the right genetic material, nucleus and chromosomes, to produce normal babies. 
These sperm can be used with IVF or ZIFT, assisted reproductive technology procedures that place the sperm in direct contact with the egg. Sperm can also be aspirated from the testicles in a surgical procedure called testicular sperm aspiration, or TESA. These sperm are also typically not motile and mature, but do contain the normal genetic material to produce normal babies.

 

Step Three: Egg Retrieval 
This step is the same as in the other ART procedures.

 

Step Four: Micromanipulation and Fertilization with ICSI
Specially trained embryologists and andrologists use micromanipulation techniques with the aid of microscopic instruments to enhance the chances for fertilization. In the laboratory, extra steps are taken with the eggs to remove the cumulus cells that support the surrounding oocyte, or egg. This allows they embryologist and/or physician to visualize the oocyte's maturity and suitability to undergo the ICSI procedure. The semen sample is prepared, yielding as many viable sperm as possible.The goal is to locate as many viable, healthy sperm as the number of selected eggs. While transfer of multiple successfully fertilized eggs increases the probability of success,ICSI has been proven successful with only one viable sperm and one viable egg that are able to fertilize.Once an embryo is fertilized, it is transferred back into the woman by injection into the uterus, as with IVF.

 
Who can have IVF Treatement ?
 

Am I too old ?

As a woman gets older, her eggs lose the energy needed to complete a pregnancy. The chance of genetic abnormalities also increases. 
                
However, the final decision about whether IVF treatment is appropriate for you must be made by you and your doctor. If your doctor considers it possible for you to conceive and refers you to us, you will receive our full support.