Intra-Cytoplasmic Sperm Injection (ICSI) is performed instead of regular In Vitro Fertilization (IVF). With ICSI, the eggs are retrieved the same as if you were doing conventional IVF. However, the eggs (fresh or previously frozen) and the sperm are then fertilized in the laboratory, by direct injection of a single sperm into each egg. Three days later the resulting embryos are simply placed into your uterus with no surgery, just as with IVF. Extra embryos are frozen for later attempts at pregnancy.
A variety of abnormalities can cause male infertility. Sperm can be completely absent from the ejaculate (azoospermia) or present in low concentrations (oligospermia). Sperm may have poor motility (asthenospermia) or have an increased percentage of abnormal shapes (teratospermia). There may also be functional abnormalities, which prevent the sperm from binding to and/or fertilizing the egg.
Indications for Intracytoplasmic Sperm Injection
- Very low numbers of motile sperm.
- Severe teratospermia.
- Problems with sperm binding to and penetrating the egg.
- Antisperm antibodies thought to be the cause of infertility.
- Prior or repeated fertilization failure with standard IVF methods.
- Frozen sperm limited in number and quality.
Obstruction of the male reproductive tract not amenable to repair. Sperm may then be obtained from the epididymis by a procedure called microsurgical epididymal sperm aspiration (MESA), or from the testes by testicular sperm aspiration (TESA).
This process increases the likelihood of fertilization when there are abnormalities in the number, quality, or function of the sperm. ICSI is generally unsuccessful when used to treat fertilization failures that are primarily due to poor egg quality.