A couple diagnosed today, with male factor infertility, has available many advanced diagnostic and reproductive technologies which can help to achieve their goal of becoming parents.

In any field of medical research, success is often measured in minute degrees, the impact of which may only be known to those whose careers are spent in a laboratory. Occasionally, there comes a discovery so outstanding that it revolutionizes medical treatment. Such is the case with Intracytoplasmic Sperm Injection (ICSI), a new infertility treatment utilizing micro manipulation technology that specifically addresses severe male factor infertility issues. In fact, ICSI is so remarkable that most treatments previously used have been abandoned in its favor.

In 1991 a Belgian physician pioneered the ICSI process and first reported the remarkable successes to the American Fertility Society (now known as the American Society for Reproductive Medicine) annual scientific conference. When a single sperm was injected directly into the egg, it virtually eliminated the problems and limitations found with previous male factor infertility treatments. Palermo and others studying ICSI found that not only did it address the issues of poor sperm motility and low count, but it was also successful with sperm that were considered less than ideal for a conventional IVF procedure. Today, ICSI has been successfully used to treat men with fresh sperm collected directly from the testis, epididymis and those with sperm previously cryopreserved.

The actual process of injecting a single sperm into an egg is carried out by the embryologist in the ART laboratory. A sterile glass holding pipette is used to secure the egg; an injection needle is used to pierce the egg membrane and to inject the sperm cell. Once the holding pipette secures the egg and the sperm cell has been drawn into the injection needle it takes less than 45 seconds for the sperm to be injected directly into the center of the egg. Remarkably, once the micro injection pipette is withdrawn, the egg will close and assume its original shape within 60 seconds. If all has gone according to plan, the transfer of the resulting embryo(s) into the female patient can occur within 3 to 5 days of ICSI.

Based on the results of this procedure, SFIRM has incorporated ICSI as a successful treatment option for couples facing male factor infertility.

The future for the ICSI process is even more promising. Researchers expect that the current fertilization rates of 85% will continue to improve. As stated previously, sperm selection for the ICSI process focuses on available motile sperm, but it is only a matter of time until the ability to select living, but non-motile sperm will help up the odds even more for couples seeking to have a baby. Currently, results are poor with sperm that don't move, as it is not known whether they are alive or dead. The staining method currently used for determining whether non-motile sperm are dead or alive actually kills living sperm. In the near future, techniques will be developed which will help determine which sperm are alive and viable for the ICSI process without killing them with the stain.