Intra-Cytoplasmic Sperm Injection (ICSI) is a modification of the in vitro fertilization (“Test-tube baby”) technique where the egg is fertilized outside the body by injecting the sperm directly into it. The embryo(s) are then introduced back into the woman’s uterus in the same way as for IVF.
ICSI is typically suitable for several groups of patients, such as:
- Men with abnormal semen parameters.
- Couples with previous poor fertilization using IVF.
The woman is given fertility drugs to stimulate her ovaries and the development of several mature follicles. Each of these follicles may contain an egg. The recruitment and development of the follicles is regularly monitored by ultrasound scans and blood tests. This is to ensure that the ovarian stimulation is both safe and effective.
Once suitable mature follicles have been produced the eggs are collected using an ultrasound-guided needle. This procedure is performed under sedation/local anesthetic. The collected eggs are then placed into culture in the embryology laboratory.
The male partner then produces a semen sample, which is then prepared in the laboratory. The aim of the preparation process is to obtain motile, normal looking sperm to be injected into the mature eggs. The Embryologist, using microscope-guided micromanipulators, injects the sperm into suitable eggs.
Next morning the eggs are inspected for signs of fertilization. Those eggs that have normal fertilization are cultured in the laboratory for another 24 – 48 hours. The development of the embryos is monitored and the patients kept advised of their progress.
Our fertility specialist performs the embryo transfer procedure. The selected embryos are introduced, through a fine catheter, into the woman’s uterus. Typically 2-3 embryos are transferred depending on the patient’s circumstances and in consultation with the patient. The embryo transfer procedure takes no more than half an hour and few women experience any discomfort.
The spare embryos are then assessed in terms of their suitability to be cryopreserved for use, by the couple, in future cycles.
The first ICSI baby was born in 1992 and subsequently many babies have been born through this technique.