Intracytoplasmic Sperm Injection (ICSI) is a process of injecting a single sperm directly into a mature egg.
ICSI is an additional method in IVF procedure that is mainly done to treat severe cases of male-factor infertility.
What is the difference between ICSI and IVF?
Intracytoplasmic Sperm Injection (ICSI) differs from IVF in that each egg is individually injected with a single sperm using a tiny needle under microscopic guidance. In a non-ICSI IVF procedure, eggs are placed in a laboratory dish in culture media together with prepared sperm. The eggs and sperm are allowed to fertilize overnight spontaneously.
The resulting fertilized eggs of both procedures (ICSI or non-ICSI) are then develop in incubator until embryo transfer procedure.
What are the steps of ICSI?
The ICSI procedure is performed by using a technique called micromanipulation. Micromanipulation uses an inverted microscopes that enable embryologists to select and pick up an individual sperm in a specially designed ICSI needle. The needle is then carefully advanced through the outer shell of the egg and egg membrane. The sperm is injected into the inner part (cytoplasm) of the egg.
There are five basic steps to ICSI (according to AmericanPregnancy.org):
- The mature egg is held with a specialized pipette.
- A very delicate, sharp, and hollow needle is used to immobilize and pick up a single sperm.
- The needle is then carefully inserted through the shell of the egg and into the cytoplasm of the egg.
- The sperm is injected into the cytoplasm, and the needle is carefully removed.
- The eggs are checked the following day for evidence of normal fertilization.
What are the ICSI success rates?
ICSI procedure usually results in normal fertilization in about 75-85% of eggs injected with sperm.
What are the risks of ICSI?
ICSI can increase IVF success rates but there are some common risks associated with ICSI:
- Damage to embryos: Not all fertilized eggs develop into healthy embryo. Unfortunately, some eggs and embryos can become damaged during the ICSI process.
- Pregnant with multiples: Couples that use ICSI with IVF have about a 30 to 35 percent chance for twins and a 5 to 10 percent chance for having triplets or more. Carrying multiples increases your chances of developing the following complications during pregnancy and childbirth: gestational diabetes, high blood pressure, low amniotic fluid levels,
bed rest, cesarean section / premature labor.
- Birth defects: Studies show that IVF with ICSI lead to a higher percentage of birth defects compared to babies conceived naturally. However, the ICSI risk of having a baby with abnormalities is very minimal (less than 1 percent). Some of these birth defects associated with ICSI include: sex chromosome abnormalities, hypospadias (a birth defect in boys where the urethra opening is underneath the penis rather than on the tip),
Angelman syndrome, and Beckwith-Wiedemann syndrome.
If you are offered to do IVF with ICSI, please ask your doctor about ICSI risks and benefits.