Intra Cytoplasmic Sperm Injection

     ICSI is the abbreviation of Intra Cytoplasmic Sperm Injection, and it is a procedure used for assisted reproduction. The technique consists of the injection of sperm in the middle of the egg, by using a needle. This method is known to be very effective to fertilize women eggs. Actually, it is used to treat some men infertility problems. It has become quite popular due to its high effective results, having into account that the couples that have some degree of impossibility to conceive a child are increasing around the globe. Some of the reasons of this trend are the fact that each time more couples choose the delay the decision of having a child.

The increasing ICSI procedure includes the use of specialized micromanipulation tools and equipment. At the same time, specific microscopes are used to choose and pick the sperm needed.

Afterwards, the sample is placed through the egg and the egg membrane, to finally be injected into the cytoplasm of the egg, which is in the center of it.

But in order to get to that stage, women must first take some medications and have an egg recovery procedure. This is very important as part of the whole ICSI procedure.

Women should have into account that only the eggs that are considerably mature can be injected. What happens when an egg is not mature is that doctors are not able to inject it with the sperm. There are some chances of getting immature eggs successfully injected, but they are very rare. Consequently, the expectation of positive fertilization is almost impossible.

Then the result would luckily be some eggs to go ahead with the ICSI technique. The average figures of ICSI are of around 75-85% of eggs injected with sperm, which is a highly appreciated result.

Among the men who are indicated to receive this treatment, this is usually decided by the doctors and clinics involved. In general, some specialists only use it for severe male infertility condition, while others choose to use it in almost every case. Some complications with males, who have infertility problems, arise when they are not willing to accept a donor sperm. In those cases, there are high chances of choosing the ICSI procedure to have the opportunity of conceiving a child.

The application of the ICSI technique has grown over the last years, and the cases most common in which the couples choose it, or are recommended to, are when the male has sperm concentrations below the 15 to 20 million per milliliter; when sperm motility is below the 35%; and when there is a very poor sperm morphology.

However, other cases less common are those when couples have a low yield of eggs at egg recovery. That way, the ICSI procedure is intended to get a higher percentage of eggs fertilized, which is rarely reached with the conventional insemination of the women eggs.

After the procedure is done, the next step is to check if there is evidence of the eggs being fertilized, within 24 hours. But it is important to have into account that, a fertilized egg does not mean a pregnancy success. In spite of this, the fact that the women eggs in these cases are usually healthy, the rates of pregnancy are higher than other common in vitro fertilization procedures.

Some of the factors that determine the success of the ICSI success rates are: the specific characteristics of the eggs, the qualification of the specialist in charge of the procedure, the level of the facilities, and the quality of the eggs, among others.

And having the above mentioned, the quality of the eggs is the key aspect that determines, consequently, the quality and viability of the embryos.

According to official figures, 10.000 babies have been conceived and born as a result of the ICSI procedure. What’s more, all of the babies mentioned were completely healthy.

The technique was first performed in 1994, in the city of San Francisco, in the United States. The first baby born as a result of the procedure was delivered in February 1995.

• The doubts around the procedure

      When facing the ICSI procedure, some couples usually have doubts and even fear of how things would turn out. One of the most common fears is the eggs being damaged. As regards that aspect, there are very small chances of having eggs irreparably damaged, approximately the 5% of the women eggs.

Other common problem that may arise is the risk of having a baby with a chromosomal abnormality in the X or Y chromosomes. The figures of that issue are of only 0.8%.

There are also other factors indicated, which are quite rare, and depend of several aspects: congenital heart problems of children; risk of miscarriage; and risk of infertility in the children conceived when they reach their adulthood.

Despite the issues mentioned there are several reasons to choose the ICSI procedure. Doctors recommend it especially for cases of couples with sperm abnormalities, having into account that the risk of reduced fertilization is quite high without the ICSI technique.

Other frequently asked question is if there differences in embryo quality or pregnancy rates, having into account both ICSI and non-ICSI embryos. Specialists state that there isn’t any clear difference in the embryos quality obtained with ICSI embryos, after comparing them with non-ICSI embryos. At the same time, it hasn’t been registered any difference in pregnancy figures of ICSI embryos over non-ICSI embryos.