ICSI is a laboratory technique and a form of micromanipulation, in which a single sperm cell is injected directly into a mature egg using a glass needle called a micropipette. This technique is used to prepare the gametes for the obstention of embryos that may be transferred to a maternal uterus.
- Woman is stimulated for follicle production and egg recovery as in IVF.
- Single sperm is taken from male partner’s semen or surgically extracted from his testes or epididymis.
- The mature egg is held with a micropipette.
- Injecting needle is used to immobilize and pick up of a single sperm.
- The needle is then carefully inserted through the shell of the egg and into the ooplasm.
- The sperm is injected into the ooplasm, the needle is carefully removed and oocytes are left for the fertilization in an incubator.
Mostly ICSI is indicated for the cases with:
- Oligoasthenoteratozoospermia
- Previous failed fertilization.
- When fertilization rate has been unexpectedly poor.
- Patient with surgically retrieved spermatozoa (TESA, PESA and MESA) either for azoospermia or man with high DNA fragmentation.
- Patient who want to go for PGS or PGD
ICSI is a procedure which effectively eliminates male infertility by introducing sperm cell directly into an egg, hence increases chances for fertilization for male factor.
Right choice if you have male factor infertility/ repeated IVF failure.
Mandatory ICSI:
- ICSI is only choice of method for azoospermic men to become father.
- TESA / TESE ICSI is also preferred for men with high sperm DNA fragmentation, azoospermia and for men with the variable count per ejaculate from a standard laboratory.
ICSI conceived children are not at a higher absolute risk of any disease or illness.
Intracytoplasmic morphologically selected sperm injection (IMSI) is a variation of ICSI that uses a high power microscope to select sperm. This allows embryologists to look at the sperm in greater detail at 6600X magnification.
DNA damage occurs at the post-testicular level, hence testicular sperm may have a better DNA integrity than ejaculated sperm.