How is ICSI Performed?

IVF is a common type of fertility treatment. This involves harvesting eggs and sperm from the couple, fertilising the egg with sperm in a lab and reintroducing the fertilised egg to the uterus. The fertilised embryo then develops into a fetus in the woman’s womb.

If the sperm count is low or the sperm has very poor motility a specialized procedure may be performed to insert a single viable sperm into the egg to fertilize it. This is known as an Intra-cytoplasmic sperm injection (ICSI). This procedure is usually recommended in cases where the couple has already undergone at least one cycle of IVF unsuccessfully.

The ICSI Process

ICSI is performed with the help of a technique known as micromanipulation. This involves the use of very fine surgical tools and a high powered microscope. Before the procedure, the female partner must take a course of fertility medication to stimulate the production of eggs.

There are 5 steps to the ICSI procedure:

• Step 1 : The sperm sample is surgically extracted from the man’s testicles or isolated from his semen sample.
• Step 2 : Eggs are surgically harvested from the woman’s ovaries.
• Step 3 : A very fine hollow needle is used to inject a sperm cell into the egg.
• Step 4 : The fertilized egg is observed in a laboratory for signs of growth and development.
• Step 5 : Once the egg begins to show signs of normal development, it is reinserted into the woman’s uterus so that it can implant itself to the uterus walls and develop as a fetus.

After this stage, pregnancy carries on normally.

When is ICSI Considered?

ICSI is usually recommended in cases where:

• The man has a sperm count much lower than 20, 000,000 sperm per millilitre of ejaculate. It can even be used with a sperm count as low as 1 or 2 million / ml
• The man has abnormally poor sperm motility.
• The man’s semen has a high incidence of antisperm antibodies that attack and damage sperm.
• The man produces sperm but it is not present in the ejaculate substance. This may result from a vasectomy reversal or a block vans deferens.
• The quality and amount of frozen sperm are very low.

Side Effects of ICSI

Like any other surgical process, ICSI also has some risks associated with it. Some of the potential issues that could arise are:

• The egg may be damaged
• The embryo may not grow and develop after fertilisation
• In rare cases, it may lead to genetic defects.Most birth defects are due to the poor quality of sperm and NOT due to the procedure of ICSI. Most of these are minor defects of urogenital system which can be surgically corrected post birth of the child.

Your doctor should be able to guide and prepare you through the process.