ICSI (Intracytoplasmic sperm injection)
There are many steps involved in the process of conceiving a child, and any one of a variety of problems can prevent the sperm from making its journey to fertilize the egg. Sometimes the man does not produce enough sperm, the sperm can’t swim properly, or the sperm can’t penetrate the egg. Other factors which could affect a man’s fertility include infection, hormone imbalances, injury, varicoceles, and psychological stress.
Today, a couple diagnosed with male factor infertility has many advanced diagnostic and reproductive technologies available which can help them achieve their goal of becoming parents.
In any field of medical research, success is often measured in small degrees, the impact of which may only be known to those whose careers are spent in a laboratory. Occasionally, a discovery comes along that is so outstanding it revolutionizes medical treatments. Such is the case with Intracytoplasmic Sperm Injection (ICSI), a proven infertility treatment utilizing micro-manipulation technology that specifically addresses severe male factor infertility issues. In fact, ICSI is so remarkable that most male factor treatments previously used have been abandoned in favor of ICSI.
A Belgian physician pioneered the ICSI process in 1991 and first reported his remarkable successes at the American Fertility Society (now known as the American Society for Reproductive Medicine) annual scientific conference. When a single sperm was injected directly into an egg, it virtually eliminated the problems and limitations found with previous male factor infertility treatments. Palermo and others studying ICSI found that it not only addressed the issues of poor sperm motility and low count, but it was also successful with sperm considered less than ideal for conventional IVF procedures. Today, ICSI has been successfully used to treat men with fresh sperm collected directly from the testis and epididymis, as well as those whose sperm was previously cryopreserved.
The actual process of injecting a single sperm into an egg is carried out by the embryologist in the Assisted Reproductive Technology (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 following ICSI.
Based on the remarkable results of this procedure, IVFMD incorporates 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. Current results with sperm that don’t move are poor, for it is unknown whether these sperm are alive or dead (the staining method currently used to determine 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.