How can ICSI help in Infertility?

Your IVF centre may recommend you IVF-ICSI for treatment of male factor infertility. These are the conditions in which you may require an ICSI procedure:

• Less sperm count
• Poor sperm movement or motility
• Abnormally shaped sperm 
• Poor sperm quality where your sperm is unable to penetrate the egg
• Sperm retrieved from testicular sperm extraction. It is done when you cannot ejaculate, but you are producing sperm
• Retrograde ejaculation where sperm is retrieved from your urine

• You are using frozen sperm, and the sperm does not seem active.
• You are taking PGD (preimplantation genetic diagnosis).
• In your previous IVF cycles, your partner’s eggs were not fertilized, even though the number of eggs was high and sperm was healthy.
• Your doctor may also recommend ICSI when you use frozen oocytes and the eggshells become hardened.
• If you are opting for IVM (in vitro maturation) where eggs are retrieved before maturity. In such a case, ICSI is very effective

There are 6 steps involved in ICSI. They are:

1. Your specialist retrieves the oocytes from your partner. It happens with the help of transvaginal oocyte retrieval procedure.
2. After that, your sperms are on the same day the eggs are collected.
3. Your doctor stabilizes the egg using a holding tool by applying gentle suction through a microinjector.
4. With a sharp, delicate, and a hollow needle, your doctor will immobilize the sperm and gently pick it up.
5. Your selected sperm is injected directly into the cytoplasm of the egg. It is done with the help of a needle, which your specialist carefully removes from the egg.
6. Finally, your specialist places the egg into cell culture. Your doctor keeps checking for signs of fertilization after 40-70 hours.

After your procedure finishes, your doctor will inject the embryo into your partner’s uterus. All you need to do after that is wait for signs of pregnancy.

ICSI couples with male factor infertility have achieved 70 to 80 per cent of fertilization rate for all eggs injected, which is equivalent to fertilization with normal sperm. The pregnancy rates achieved through ICSI are comparable with those attained through IVF in couples who have no male factor infertility.

Some of the advantages of ICSI include:

• ICSI can use fertilized eggs of the highest quality and treat serious infertility in men.

• It can solve infertility problems due to low sperm count, poor sperm motility, or low sperm quality.

• ICSI increases fertilization chances during In-Vitro Fertilization (IVF).

• ICSI is also an excellent option if you have a vasectomy.

Usually, a normal pregnancy has about 1.5 to 3 per cent risk of major congenital disabilities. ICSI has a slightly increased rate of birth defects which is still very rare.

Researches state that babies developed using artificial insemination may have a risk of imprinting defects. 

Imprinting is when some genes in the baby act differently depending on the chromosome passed by the father or mother. However, some researchers believe that imprinting defects happen even in a natural pregnancy.

Apart from imprinting defects, needle insertion could damage about 5 per cent of the eggs. Also, chromosome abnormality in ICSI is 4 times more than normal conception.

Some of the issues related to sex chromosome abnormalities:

• High risk of behaviour or learning disabilities
• High risk of miscarriages
• Heart conditions
• Increased risk of infertility in your children during their adulthood. It happens because the father may pass on male infertility genetically.

Although researchers believe that ICSI leads to birth defects, it can also be due to the abnormalities in the couples taking the procedure. If you are planning on taking ICSI treatment, consult with your doctor. They can guide you about the risks and complications related to the ICSI procedure.