What is ICSI?
ICSI, which is pronounced ick-see, stands for intracytoplasmic sperm injection. ICSI may be used as part of an IVF treatment.
In normal IVF, many sperm are placed together with an egg, in hopes that one of the sperm will enter and fertilize the egg. With ICSI, the embryologist takes a single sperm and injects it directly into an egg.
Why is ICSI Done?
ICSI is typically used in cases of severe male infertility, including:
- Very low sperm count (also known as oligospermia)
- Abnormally shaped sperm (also known as teratozoospermia)
- Poor sperm movement (also known as asthenozoospermia)
If a man does not have any sperm in his ejaculate, but he is producing sperm, they may be retrieved through testicular sperm extraction, or TESE. Sperm retrieved through TESE require the use of ICSI.
ICSI is also used in cases of retrograde ejaculation, if the sperm are retrieved from the man's urine.
ICSI may also be done if regular IVF treatment cycles have not achieved fertilization.
What is the Procedure for ICSI?
ICSI is done as a part of IVF. Since ICSI is done in the lab, your IVF treatment won't seem much different than an IVF treatment without ICSI.
As with regular IVF, you'll take ovarian stimulating drugs, while your doctor will monitor your progress with blood tests and ultrasounds. Once you've grown enough good-sized follicles, you'll have the egg retrieval, where eggs are removed from your ovaries with a specialized, ultrasound-guided needle.
Your partner will provide his sperm sample that same day (unless you're using a sperm donor, or previously frozen sperm.)
Once the eggs are retrieved, an embryologist will place the eggs in a special culture, and using a microscope and tiny needle, a single sperm will be injected into an egg. This will be done for each egg retrieved.
If fertilization takes place, and the embryos are healthy, an embryo or two will be transferred to your uterus, via a catheter placed through the cervix, two to five days after the retrieval.
You can get more detailed information here in this IVF Treatment Step by Step.
How Much Does ICSI Cost?
Is ICSI Safe for the Baby?
A normal pregnancy comes with a 1.5% to 3% risk of major birth defect. While ICSI treatment carries a slightly increased risk of birth defects, it's still rare.
Some birth defects which have an increased risk with ICSI include Beckwith-Wiedemann syndrome, Angelman syndrome, hypospadias, and sex chromosome abnormalities. Still, they occur in less than 1% of babies conceived using ICSI with IVF.
There is some increased risk of a male baby having fertility problems in the future. This is because male infertility may be passed on genetically.
What is the Success Rate for ICSI?
The ICSI procedure fertilizes 50% to 80% of eggs. (Interestingly, just because a sperm is injected into an egg, it does not guarantee fertilization will happen.) Even if fertilization takes place, the embryo may stop growing.
However, once fertilization happens, the success rate for a couple using ICSI with IVF is the same as a couple doing regular IVF treatment.
Patient Fact Sheet: Intracytoplasmic Sperm Injection (ICSI). American Society of Reproductive Medicine. Accessed online July 1, 2009. http://asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/ICSI-Fact.pdf