by Corey Whelan
Intracytoplasmic sperm injection, or ICSI, is a twenty year old procedure originally designed to combat severe male factor infertility. Performed as part of an In Vitro Fertilization (IVF) protocol, this fertility technique differs from traditional IVF in one unique way.
In a standard IVF procedure each egg is exposed to approximately 50,000 sperm in order to achieve optimum fertilization results but when ICSI is performed, one lone sperm per egg is enough to do the trick. In ICSI, a single sperm is literally injected into an individual egg in the laboratory by way of a micromanipulation technique, utilizing a tiny pipette.
With traditional IVF, the man’s ejaculate is washed and then used to fertilize eggs in a Petri dish. If millions of sperm are not present in the ejaculate from which 50,000 per egg can be obtained, the odds of fertilization plummet. When ICSI is added to the In Vitro Fertilization procedure either ejaculated sperm or sperm that has been obtained surgically can be used for fertilization. This is great news for men who have undergone cancer treatment and are considered sterile, or even men who have had irreversible vasectomies.
If an intended dad’s semen does not contain a sufficient number of motile sperm, the physician may attempt to remove sperm directly from the testicles utilizing a needle. Another option might be to perform a biopsy of the testicular tissue, in an attempt to find sperm within the tissue itself. Both of these procedures if required would be performed under anesthesia.
ICSI is often indicated for the following conditions:
- Low sperm concentration (# million sperm/ ml) or count (few total sperm in an ejaculate)
- Poor motility (movement) of sperm
- Inadequate percentage of ejaculated sperm that have a normal shape (morphology)
- Blockage(s) in the male reproductive tract, causing an absence of sperm in the semen
- Sperm can’t penetrate through the egg’s outer layer (the zona pellucida)
- Failed fertilization in a prior IVF cycle
- Poor fertilization rate in a prior IVF cycle
- Irreversible vasectomy
- Klinefelter’s Syndrome (XXY Condition)
- Cancer survivors who have undergone chemotherapy, radiation, or both who now have diminished sperm production
- Spinal cord injury paralysis