What is Intracytoplasmic Sperm Injection: ICSI?
Dr Chaithra S K
Kalyan nagar, Bengaluru Feb 9, 2017
ICSI means intracytoplasmic sperm injection, simply meaning injection of sperm into egg
ICSI is an effective method to fertilize eggs in the IVF lab once they have been extracted from the female
It is mainly used in significant male factor infertility cases as in low counts, motility and previous fertilization failures.
IVF with ICSI uses specialized micromanipulation tools and equipment along with inverted microscopes that enable the embryologists to choose and pick up single best sperm in a specially designed ICSI needle.
The ICSI needle is carefully inserted through the outer shell of the egg into the membrane - and the sperm is injected into the inner cytoplasm of the egg.
This mostly results in a normal fertilization in about 80% of eggs injected with sperm.
However, first the female must be readied with medications and have an egg retrieval procedure so as to obtain several eggs for IVF and ICSI.
When to opt for ICSI
Severe male factor infertility cases that do not want donor sperm insemination.
Couples with male infertility cases as:
Sperm concentrations of less than 15-20 million per ml
Low sperm motility - less than 32%
Very poor sperm anatomy
Having previously failed IVF or a low fertilization rate (low percentage of mature eggs that were normally fertilized).
In certain cases for couples who have a low yield of eggs at egg retrieval stage. In such scenario, ICSI is used to try to get a higher percentage of eggs fertilized compared to conventional insemination of the eggs (mixing eggs and sperm together).
ICSI for frozen thawed egg
The grown egg is grasped with a specialized holding pipette.
A very delicate, sharp and hollow needle is used to incapacitate and pick up a single sperm.
This needle is then cautiously inserted through the shell and in to the center (cytoplasm) of the egg.
The sperm is introduced in the cytoplasm and the needle is withdrawn.
The eggs are checked the following morning for confirmation of normal fertilization.