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With an increase in fertility treatments, assisted reproductive technology (ART) has now become a popular choice for individuals and couples seeking help getting pregnant. One of which is ICSI.
ICSI is now one of the most well known and regularly used treatments for male factor infertility. Read on to find out more about what it involves and typical success rates.
What is ICSI fertility treatment?
ICSI (intracytoplasmic sperm injection) is a fertilisation treatment that is effective for treating male infertility. It is usually performed as part of an IVF cycle however instead of the eggs and sperm being placed in a dish to fertilise, a single healthy sperm is selected and injected directly into each egg under a microscope by a specially trained embryologist. Following the ICSI procedure, the eggs are monitored for signs of fertilisation in the same way as with IVF, this typically occurs within 16-18 hours. Like IVF, only a mature egg is capable of fertilisation. The viable embryos are then placed in an incubator to continue their development for the next 2-5 days. The embryos are either transferred for a possible pregnancy or frozen if they are intended to be used in the future.
What are the fertilisation rates using ICSI?
Like most fertility treatments, ICSI fertilisation rates can vary. This may be from how the sperm was collected, such as surgical retrieval, fresh or frozen sperm, or be due to other individual factors that can impact fertilisation rates. However, with generally favourable fertilisation rates, using the ICSI technique has made this method a popular choice for fertility patients.
Why choose ICSI?
As the sperm directly fertilises the egg, it bypasses any potential problems the sperm may have in getting inside the egg. It is the most common treatment used for male factor fertility as it can overcome any issues with sperm movement or sperm numbers.
Because ICSI only needs one or a small number of sperm to fertilise an egg or eggs, men with no sperm or a few sperm in their ejaculate can now have a chance of fathering a child. ICSI may also be used to fertilise eggs that have previously been frozen, or it can be used when sperm has been retrieved surgically and frozen for future use.
What are the risks of ICSI treatment?
Like all types of treatment, there are small risks for those who decide to have ICSI. This can include a risk that the eggs may be damaged when they are injected with the sperm, and a possibility that a boy conceived and born as a result of ICSI may inherit his father or donor’s infertility.
However, it is important to note that there is not enough evidence and it is too early to know if this is the case. Currently early studies on children born from ICSI are promising however ongoing research is needed. As in all cases of treatment it is important to discuss the risks vs benefits with your fertility doctor so you can make an informed decision that is right for you and your partner.
Where can you get ICSI treatment?
Currently over 60 countries worldwide now use ICSI; this is because it yields a high fertilisation and pregnancy rate and is now also used for other indications. Initially the main treatment use for ICSI was for male factor fertility. However, over time further indications for ICSI have included fertilisation for frozen eggs, failed fertilisation following IVF and for those embryos that will be tested for genetic conditions as it lowers the chance of sperm DNA contamination which may impact on the genetic test results.
ICSI can also be offered to couples with Hepatitis B, C or HIV as the use of a single sperm for fertilisation alongside removal of the seminal fluid can dramatically reduce the chances of viral transmission. Other recommendations can be if there is a low egg yield during treatment, a poor response to treatment or in some cases the patient’s individual choice.
In summary ICSI is a fertilisation treatment that is usually offered for male factor infertility, however with good fertilisation and pregnancy rates it is also now used for other fertility treatments, offering more treatment choice to patients undergoing assisted reproduction therapy.
If you’d like to find out more about ICSI and fertility treatments, book an appointment with one of our specialist fertility coaches and nurses who can answer any questions you might have. You can also find out more about our other experts who can support you with fertility today.
Kate, Fertility Nurse
Kate is a passionate and very caring senior women’s health nurse specialising in fertility. She has over 15 years' experience in gynaecology with 6 years working for a leading IVF clinic.