Intracytoplasmic Sperm Injection (ICSI) is an assisted reproductive technique utilized to treat moderate to severe form of Male Factor infertility characterized with oligozoospermia (i.e. low sperm count) and asthenozoospermia (i.e. poor motility). It is the injection of a single sperm cell directly into an oocyte (egg) to create an embryo. ICSI is a modified form of Invitro Fertilization as fertilization takes place outside the woman body, the only different being that in conventional IVF sperms and oocytes (egg) are cultured together in an effort to achieve fertilization.
The advent of intracytoplasmic sperm injection has revolutionized the treatment of male infertility, as individuals with moderate to severe form of oligoasthenozoospermia (i.e. low sperm count and poor motility combined) can give birth to genetically related children.
ICSI procedure is performed in the embryology by an embryologist using a special kind of micromanipulation equipment with aid of inverted microscope, holding needle which is used to stabilize the egg and injection needle used to inject the sperm into the egg.
Following egg retrieval, the retrieved eggs are denuded (i.e. removal of the cells surrounding the egg) and the sperm cells are washed and screened, the selected sperm is immobilized and loaded into the injection needle. The egg to be inseminated is stabilized using the holding needle and gently the shell (zona pellucida) of egg is pierced with the injection needle to reach the egg and the sperm is gradually released into the egg’s ooplasm. The inseminated egg is then returned back to the incubator for culturing and hopefully may result to pregnancy.
WHO QUALIFIES FOR THIS SERVICE?
Intracytoplasmic sperm injection is indicated in patients with the following;
- Moderate to severe form oligoasthenozoospermia (i.e. low sperm count and poor sperm motility)
- Patients who had in-vitro-fertilization before, but had a low fertilization rate
- Couples with obstructive azoospermia requiring the use testicular sperm extraction (TESE) or microscopic epididymal sperm aspiration (MESA).
WHAT IS THE SUCCESS RATE?
The success rate using ICSI is significantly increased when compared to IVF, particularly for couples with moderate to severe male factor infertility, the pregnancy outcome between IVF and ICSI for couples with unexplained infertility is the same.
WHAT IS THE CUMULATIVE SUCCESS RATE?
The cumulative success rate for ICSI is similar to the rate for IVF, expect of course in cases of moderate to severe oligoasthenozoospermia, where ICSI clearly have higher cumulative success rate.
WHAT IS THE COST OF THIS SERVICE?
The cost of one cycle of ICSI, depend on the type of program and use of medication.