Couples with severe male factor infertility or those who have had repeatedly low or no fertilisation with conventional IVF are offered intracytoplasmic sperm injection (ICSI). This treatment has been a major step forward in assisted reproduction technology. In simple terms, ICSI is an extension of IVF and works by bypassing the need for the sperm to penetrate the egg.Following egg collection the mature eggs are specially treated to remove the cumulus cells surrounding them. A single sperm is selected and drawn up into a very fine, specially prepared glass needle. The embryologist then injects this sperm directly into the egg under microscopic control using specialised instruments.
Once injected, the eggs are placed in an incubator until the following morning before being examined for signs of fertilisation. At 24 hours post fertilisation check the fertilised eggs, or embryos, are re¬examined for signs of division. The embryo transfer may take place on D2 or the following day (day 3) or (day 5) – Blastocyst transfer.
We might recommend ICSI when-
• the number of sperm are low
• Motility of sperm are low
• high number of abnormal sperm
• Surgically collected sperm –TESA, PESA, TESE, MESA etc