What is Intracytoplasmic Sperm Injection (ICSI)?
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Intracytoplasmic Sperm Injection (ICSI)
Direct injection of a single sperm into an egg under microscope (micromanipulation). This procedure is used when there is a severe male factor such as a very low sperm count or poor quality sperm.
How it’s done
The woman is given fertility drugs to stimulate her ovaries to develop several mature eggs for fertilisation. (As you know from sex education, women normally release only one egg a month.)
Once the eggs are ready, the man and the woman undergo separate procedures. The doctor retrieves sperm from the man, in most cases from a testicle with a needle under anaesthetic (the procedure is called percutaneous epididymal sperm aspiration). If this technique doesn’t remove enough sperm, the doctor will take a biopsy of testicular tissue, which sometimes has sperm attached. After giving the woman a local anaesthetic, the doctor will remove her eggs using a fine, hollow needle. (An ultrasound helps the doctor locate the eggs.)
A lab technician then isolates individual sperm and injects them into individual eggs. Two days later the fertilised eggs become balls of cells called embryos. The doctor transplants two or three embryos into the woman’s uterus through her cervix using a thin catheter. (Extra embryos, if there are any, may be frozen in case this cycle isn’t successful.) One embryo may attach to the uterine wall and continue to grow. (In a third of ICSI pregnancies, more than one embryo will implant.) After about two weeks, the woman can take a pregnancy test.
What are the known risks of ICSI?
ICSI is a relatively new treatment, the first children having been born in 1992. Although information to date suggests that it is safe, couples considering ICSI should be made aware of several issues including the possibility of unknown risks.
What are the advantages?
ICSI gives men with a very low sperm count a chance at conceiving their genetic child. The treatment also helps men who are missing their vas deferens, the pair of tubes that carries seminal fluid from the testes to the penis, and men who are unable to reverse a vasectomy.
What is the success rate of ICSI?
The success rates for all IVF treatments vary between patients, however ICSI produces similar live birth rates to standard IVF treatments. Slight differences in ICSI fertilisation and pregnancy rates with different causes of infertility have been observed.
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