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What Is ICSI?

ICSI, or Intracytoplasmic Sperm Injection, is a specialised technique where a single sperm is carefully injected directly into an egg to assist with fertilisation. Conducted by an experienced embryologist in a laboratory, ICSI is especially useful for addressing male infertility issues like low sperm count, poor motility (movement), or abnormal sperm shape. While certain male infertility factors can be treated without this method, ICSI provides a targeted solution for couples where traditional fertilisation methods may not succeed. A thorough fertility assessment is essential to determine the best approach.

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ICSI or Intra-Cytoplasmic Sperm Injection

How ICSI Addresses Male Infertility

ICSI directly addresses male infertility by selecting and injecting a single healthy sperm into an egg, overcoming natural barriers to fertilisation. This technique is beneficial in cases where:

  • Sperm count is low, or motility (ability to move) is poor, limiting fertilisation potential
  • Sperm morphology (shape) is abnormal, making it difficult for sperm to naturally penetrate the egg
  • Sperm are unable to swim effectively or lack the capability to penetrate the egg unaided

In these situations, ICSI allows for fertilisation by bypassing the challenges of traditional IVF, using the best sperm available to achieve successful fertilisation.

When is ICSI Recommended?

ICSI is often advised in cases of:

  • Low sperm count: When the concentration of sperm is insufficient for traditional fertilisation
  • Poor sperm motility: Reduced movement or poor swimming ability that hinders the sperm’s ability to reach and penetrate the egg
  • Abnormal sperm morphology: Unusual sperm shapes that make it challenging for sperm to fertilise an egg naturally
  • Prior IVF Failures: When previous IVF attempts with standard fertilisation have had disappointing results.
  • Sperm Retrieval Procedures: Required when there are blockages or absence of sperm in the ejaculate; sperm can be retrieved surgically and used in ICSI to achieve fertilisation of an egg.

The Process

How ICSI Works

The ICSI process includes several stages, as outlined below:

  • Ovarian Stimulation: The female partner undergoes ovarian stimulation, using medications to produce multiple mature eggs.
  • Egg Retrieval: Once assessments indicate that the eggs are likely to be mature, they are retrieved from the ovaries through a minor procedure.
  • Sperm Collection: Sperm is collected from the male partner or a sperm donor. If necessary, sperm retrieval may be performed surgically.
  • Sperm Injection: A single, selected sperm is injected directly into each egg to attempt fertilisation.
  • Embryo Monitoring: Fertilised eggs are observed as they develop into embryos over a period of 5-6 days.
  • Embryo Transfer: Once embryos reach the ideal developmental stage, they are transferred into the uterus usually one at a time to establish a pregnancy.

Several factors impact the success of ICSI:

  • Age: Women under 35 generally see higher success rates, while success declines significantly for women over 40 due to egg quality and ovarian reserve. Success is very low in women 43 years and older.
  • Health and Lifestyle: Overall health, weight, diet, and lifestyle can influence fertility outcomes. Conditions like diabetes, thyroid disorders, or hormonal imbalances may also play a role.
  • Underlying Fertility Issues: Female factors, including poor egg quality, endometriosis, or blocked fallopian tubes, as well as male factors, such as low sperm count or poor motility, can affect ICSI outcomes.
  • Ovarian Reserve and Sperm Quality: The number of healthy eggs (ovarian reserve) and the quality of sperm impact the fertilisation rate and embryo development. Higher-quality sperm and eggs generally improve success rates.

Potential Risks of ICSI

ICSI is generally safe, but as with any medical procedure, there are potential risks:

  • Egg Damage: Rarely, the injection process can cause damage to the egg.
  • Genetic Conditions: In cases of male infertility, there may be a slight risk of passing on genetic issues. Genetic counselling and screening are advised if there are known risks.
  • Multiple Pregnancies: Transferring multiple embryos increases the chances of twins or higher-order multiples, which carry additional pregnancy risks.
  • All assisted reproductive procedures are associated with a small increased risk of genetic and congenital disorders in the resulting children.

FAQs

For further information or to schedule a consultation, please reach out to Dr. Knight’s clinic. Our team is ready to answer questions and support you at every stage.

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Related services

We offer a variety of services to support you on your fertility journey, tailored to meet your individual needs.

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In Vitro Fertilisation (IVF)

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Intrauterine Insemination (IUI)

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Ovulation Induction (OI)

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Resources to support you

We’re here to guide you every step of the way. Explore our helpful resources, designed to provide information and support throughout your fertility journey. Whether you’re just starting or seeking more in-depth knowledge, you’ll find valuable insights to help you make informed decisions.

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ICSI or Intra-Cytoplasmic Sperm Injection
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Understanding Female Reproduction and Common Causes of Infertility: How Dr. Rachael Knight Can Help
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Understanding Male Reproduction and Common Causes of Infertility: How Dr. Rachael Knight Can Help
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