What is ICSI?

Intracytoplasmic sperm injection (ICSI) is a powerful assisted reproductive technology (ART) that dramatically increases the potential for fertilization in many cases of male infertility. The ICSI procedure directly introduces an individual sperm cell into each of the eggs obtained during the IVF (in vitro fertilization) process. The resulting embryo is then readied for transfer to the uterus to initiate pregnancy.

Why Use the ICSI Procedure?

ICSI is used most often when male infertility is present - sperm count or motility is in the subnormal range, the sperm itself is abnormal, or when a sperm retrieval procedure is used to collect sperm directly from the testes or epididymis. In these cases, neither IUI nor routine IVF is effective. Routine IVF procedure involves simply mixing a large quantity of sperm with the retrieved eggs and incubating them in culture media to produce an embryo. The success of this procedure therefore depends upon having enough viable, healthy sperm to achieve fertilization. Because the ICSI procedure injects a single sperm directly into the egg, it is a highly targeted approach to IVF when standard methods are not an option, or have failed.

At SCRC, our fertility specialists have performed thousands of ICSI procedures with high success rates.

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 – Low sperm concentration in the ejaculate (a low sperm count) hinders effective 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 sperm abnormalities exist, fertility is generally inhibited. ICSI has proven to be an effective procedure when any of these common causes of male infertility are present. However, 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 (intracytoplasmic sperm injection) 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).

Does ICSI Have Risks?

As in all aspects of medicine, ICSI comes with its own set of risks and benefits. However, the nature of the ICSI procedure is almost universally considered to be low-risk. There are no risks to the male partner once the sperm has been obtained and only negligible risks if sperm retrieval techniques are used.  There may be a very slightly elevated risk of babies conceived with ICSI having certain genetic abnormalities due to the fact that the sperm used may have been abnormal. These abnormalities, however, are usually minor, and risks can be mitigated prior to pregnancy with careful embryo selection and preimplantation genetic diagnosis (PGD). In summary, numerous studies as well as our experience as fertility specialists at SCRC have demonstrated ICSI to be a safe and effective procedure for IVF in male infertility.

What About the Cost of the ICSI Procedure?

Because ICSI is a highly delicate micro-manipulation procedure, the cost is higher than that of routine IVF. Cost varies depending on the complexity of your individual case, but rest assured that SCRC is committed to helping you achieve your goal of parenthood, and we offer a variety of financing options designed to make the cost ICSI and all of our procedures manageable and affordable.