Intracytoplasmic sperm injection (ICSI) is another assisted reproductive technology that dramatically increases the potential for fertilization. It directly introduces an individual sperm cell into each of the eggs obtained during the IVF process. At SCRC, our fertility specialists have performed thousands of ICSI procedures with great success. ICSI is used when semen values (such as count and motility) fall into the subnormal range or when sperm are obtained directly from the testes or epididymis.

Male Infertility

A number of different problems with the sperm can contribute to male infertility:

• Azoospermia – Sperm is totally absent in the ejaculate fluid
• Oligospermia – Sperm is present in concentrations too low to be effec tive in conception
• Asthenospermia – The sperm has poor motility (ability to move)
• Teratospermia – The shape and form (morphology) of the sperm are abnormal Additional problems can occur if there are abnormalities during the steps the sperm must go through for fertilization, such as binding to and penetrating the egg.

When any of these important characteristics of sperm function are deficient, fertilization will generally be inhibited. ICSI has proven to be an effective technology when any of these conditions are present, but ICSI is generally not effective when used to treat infertility that is due primarily to poor egg quality, a possible cause of female infertility.

Indications for ICSI

The following conditions may make a patient eligible for ICSI treatment:

• Low numbers of motile sperm with normal appearance
• Problems with sperm binding to and penetrating the egg
• Anti-sperm antibodies (immune or protective proteins which attach to and destroy sperm) that prevent fertilization
• Prior or repeated fertilization failure with standard IVF culture and fertilization methods
• Frozen sperm collected prior to cancer treatment that may be limited in number and quality
• Absence of sperm due to blockage. In this situation, sperm are obtained from the epididymis by a procedure called microsurgical epididymal sperm aspiration (MESA) or from the testes by testicular sperm aspiration (TESA).

As in all aspects of medicine, ICSI comes with its own set of risks and benefits.