What is intracytoplasmic sperm injection (ICSI)?
ICSI, or intracytoplasmic sperm injection, is a fertility treatment that involves injecting a single sperm directly into an egg during in vitro fertilization (IVF). It's commonly used to treat male infertility, or when a couple has had poor fertilization in a previous IVF cycle.
Who should consider intracytoplasmic sperm injection?
Your doctor might recommend ICSI if you and your partner have experienced fertility problems. It can be beneficial for couples with male factor infertility, which contributes to about 50% of all infertility cases, and potentially for couples who have unexplained infertility or for men who have never fathered a child.
Male fertility problems might include:
- Anejaculation (inability to ejaculate)
- A blockage in the reproductive tract that prevents sperm from being released
- Not enough sperm for artificial insemination or traditional IVF
- Sperm that is abnormally shaped (poor morphology) or they don’t move normally (poor motility)
- Sperm that has problems attaching to an egg
- Retrograde ejaculation (semen flows backward into their bladder)
- Azoospermia (no sperm in the male’s ejaculation)
Other reasons to try the ICSI procedure include:
- Having previous IVF that did not result in fertilization
- Using in vitro matured eggs, which means that eggs not ready to be fertilized were matured in a laboratory
- Using previously frozen eggs (cryopreservation) to conceive
How to prepare for ICSI
Preparing for ICSI may require the same preparation as IVF. Your infertility specialist may order screening tests, such as:
- Hysteroscopy: to view the inside of your uterus
- Ovarian reserve testing: a blood test that tells your doctor how many eggs you have available
- Semen analysis: a test used to measure sperm count and quality
You and your partner may also need tests to see if you have sexually transmitted infections, such as HIV, that may interfere with IVF or reduce the chances of success with ICSI.
The ICSI procedure
The ICSI process is similar to IVF, but instead of allowing the sperm to naturally penetrate the egg, an embryologist injects the sperm into the egg's cytoplasm. This process increases the chances of fertilization by bypassing any issues the sperm may have with entering the egg. Here are some steps involved in the ICSI process: