What it is ICSI treatment and how can it help fertility?

With In-vitro Fertilisation (IVF), eggs are fertilised when sperm is introduced.  Essentially, this is the same process that takes place during conception, but in this case, it has taken place outside the body.

A key factor in achieving a successful outcome using IVF is that the volume and quality of sperm.  However, what happens if the volume or quality of sperm is sub-optimal?

With advances in the field of Assisted Reproductive Techniques (ART), a process called intracytoplasmic sperm injection, or ICSI, was developed, to address this problem and maximise a couple’s chances of a successful outcome.

What is ICSI?

In an Intracytoplasmic sperm injection (ICSI) cycle, the process of collecting eggs and sperm is similar to conventional IVF.  The process differs in how ferilisation is achieved. ICSI refers to a laboratory procedure whereby a single sperm cell is injected directly into each egg, by highly skilled laboratory team (embryologists).

The next stages are the same as in an IVF cycle.  The eggs are allowed to develop into embryos and after a period of time, some will be implanted back into the womb, to hopefully result in a pregnancy and live birth.

Who needs ICSI?

ICSI is commonly used to overcome severe male factor infertility, allowing for pregnancy rates comparable to IVF.

Common indicators for ICSI, include:

  • Low sperm count
  • Sperm motility – When the sperm cannot move properly
  • When sperm has be retrieved surgically from the epididymis (MESA/PESA) or the testes.
  • (TESE/TESA), from urine or following electro-ejaculation
  • When there are high levels of antibodies in the semen
  • When there has been a previous fertilisation failure using conventional IVF

What are the stages of an ICSI cycle?

Like IVF, ICSI treatment typically entails six stages:

  • Down Regulation: The patients’ ovaries are essentially ‘turned off’, using medication, to better control ovulation and egg maturation during a treatment cycle.
  • Stimulation: Using medication, the patients ovaries are stimulated to produce as many eggs as possible, within predefined parameters, to avoid under/over response.
  • Monitoring: During the stimulation phase of the cycle, the patients, response to the medication is monitored through by ultrasound scans and by measuring hormone levels in the blood.  During this stage, the consultant is monitoring how the follicles are developing.
  • Egg Collection: Once matured, the eggs will be collected using a needle that’s passed through the vagina and into each ovary.  This is done under ultrasound guidance.
  • Fertilisation: Each egg is fertilised by being injected with a single sperm cell, by a member of the laboratory team.
  • Transfer: After between 3 to 5 days of development, up to two embryos will be re-implanted into the womb to continue to mature and grow and will hopefully result in a healthy baby being born.

Getting Started With ICSI

Usually, the first step is for the patient to meet with the General Practitioner (GP), who will refer them on to a Gynaecologist or Fertility Consultant for investigations and then treatment.  Patients can ask to be referred to a clinic or their choice, or can self-refer themselves. It therefore makes sense to do the research and search for fertility clinics online and read patient reviews to understand other patients’ experience.  But ultimately, nothing beats contacting the clinic to arrange a visit and meet with them directly.



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