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Intracytoplasmic Sperm Injection (ICSI)
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The information on this page is for all patients requiring ICSI, one of the latest techniques in fertility treatment now being used in this country. Pioneered at the Free University of Brussels, the techniques we employ are broadly based on the ones developed there.
The initials ICSI stand for Intracytoplasmic Sperm Injection. This is the process of picking up a single sperm in a fine needle and injecting it directly into the cytoplasm (body) of the egg to aid the process of fertilisation.
| Pre-Treatment Investigations |
Initial diagnostic investigation of both partners will need to be carried out along the lines of conventional IVF. This will include prior evaluation of the semen to ensure that sufficient sperm can be harvested for the ICSI procedure. Some couples will also be asked to provide blood for chromosome (genetic) screening. These tests are done to make sure that there is no increased risk to the foetus of inheriting a chromosome abnormality. If an abnormal result is discovered, appropriate counselling for the couple will be arranged.
After the above is completed, and the couple are found to be suitable for the ICSI treatment programme, the procedure would be the same as for an IVF treatment cycle. It would be necessary to stimulate the ovaries with fertility drugs so as to obtain as many eggs as possible and the egg recovery would usually take place 12 to 15 days after the drug had been started. Injections for the woman in the second half of the cycle are as for IVF cycles.
On the day of egg recovery, the male partner will need to provide a semen sample (occasionally two). About six hours after the egg recovery, the embryologist will carry out the ICSI procedure by selecting sperm for injection (one that is motile and with normal appearance).
The egg is held in place with a fine tube, and an ultra-fine needle is passed through its shell and brought into contact with the egg's membrane. The needle is then carefully pushed through the membrane into the centre of the egg, and the sperm injected with the minimum amount of fluid.
The needle is carefully withdrawn, taking care to leave the sperm within the egg. The same procedure is then carried out to try to fertilise the remainder of the eggs.
The next morning, you will be required to phone the laboratory to find out if fertilisation has occurred. If so, we will give you an appointment (usually 2 – 3 days after egg recovery).
On the fifteenth day (day 15) after egg recovery you will be asked to attend the Centre for a pregnancy test and the results will be known later that day. If you are pregnant, we will give you instructions for early pregnancy monitoring at The Harley Street Fertility Centre. Pregnancies following ICSI are monitored in the same way as IVF pregnancies in the early stages.
By the very nature of the technique, and the fact that ICSI is generally used in cases of severe male factor infertility, fears have been raised that it may lead to an increase in abnormalities of the children born.
The Free University of Brussels. which has the largest ICSI programme in Europe, has undertaken detailed monitoring of all children born.
| Advantages of ICSI over IVF |
ICSI can be performed for men who have very few numbers of sperm in their semen, too few for IVF.
| Disadvantages of ICSI over IVF |
The piercing of the egg's membrane may lead to damage. This will be evident either during, or immediately after the procedure.
These eggs will not be used in treatment and data from Brussels suggests that 10 - 15% of the eggs will be lost in this way
| Patients who would be suitable of ICSI |
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