Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic Sperm Injection (ICSI) is a laboratory procedure which aims to achieve fertilisation in the eggs of couples struggling with unexplained, or male factor infertility.

ICSI is the process by which an Embryologist assesses the maturity of all eggs retrieved via egg collection and selects a single good quality sperm to inject directly inside each mature egg. This method is recommended to couples who may have reduced sperm parameters, have had failed or poor results with traditional IVF in the past, or those using precious frozen sperm samples.

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What is the difference between IVF and ICSI?

In vitro fertilisation (IVF) and Intracytoplasmic Sperm Injection (ICSI) are both types of assisted insemination methods used to help couples have a baby. Essentially, this describes how the sperm and the egg come together in the laboratory setting.

IVF is a less invasive technique that involves an Embryologist preparing and placing thousands of motile sperm in a culture dish with the eggs and allowing the sperm to find their own way to the egg, which hopefully leads to fertilisation. IVF is recommended for couples whose sperm are known to meet the required reference ranges for count (number of sperm in the ejaculate), motility (how well the sperm swim), and morphology (the shape of the sperm).

Alternatively, ICSI insemination is able to bypass the first hurdle of fertilisation by eliminating the need for thousands of good swimming sperm on the day of egg collection. ICSI requires just one live sperm for each mature egg collected. These sperm are injected directly into the egg, ensuring they penetrate through the eggs outer shell – a critical process which the sperm are sometimes unable to achieve on their own.
Neither IVF, nor ICSI, are 100% effective in achieving fertilisation, however ICSI is known to successfully help couples overcome male factor infertility.

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ICSI in more detail

Once the eggs have been assessed for maturity, an Embryologist uses micromanipulation needles to select the sperm with the best motility and appearance, immobilises the sperm and draws it into the microinjection needle. The single sperm is then injected into the mature egg with precision and accuracy using high powered microscopy.

ICSI and male factor infertility

Couples may be recommended ICSI in hopes of overcoming suboptimal sperm parameters which may be contributing to struggles conceiving naturally, or with traditional IVF. In some cases, the egg and sperm simply may not be interacting with each other as expected. For these couples, ICSI may provide a chance at successfully creating their own biological embryos.

ICSI may help overcome the following limiting sperm factors:

Low motility: limited forward progression of the sperm where they may struggle to reach and interact with the egg
Low concentration: limited number of sperm where the chance of a sperm fertilising the egg becomes reduced
Known case of elevated sperm DNA fragmentation
Surgically retrieved sperm that may have limited quality/concentration
Semen collected and frozen prior to medical treatment/chemotherapy, where the sperm may have limited quality/concentration
Presence of antisperm antibodies within the semen (immune system proteins which inhibit sperm function)

What happens after an ICSI insemination?

After an ICSI insemination, the eggs are placed into our Time-Lapse Incubators for continuous observation. Fertilisation can be confirmed the following day, and the developing embryo is then given 5-6 days to grow before either embryo transfer or freezing. At Oasis, the couple will receive a call from an Embryologist the day after egg collection with their fertilisation results and updates on the embryo development every second day thereafter.

Are there any risks associated with ICSI insemination?

Studies show that children born from both ICSI or IVF created embryos have the same risk of congenital or endocrine abnormalities as naturally conceived children. As ICSI puts the egg under more stress than IVF, there is a very small chance the egg may become damaged through this process. While rare, if an egg does not withstand the ICSI then it will be unable to fertilise and is considered unviable. Our Embryologists perfect the skill of ICSI over many years, constantly improving and advancing their techniques so that the egg and sperm remain as safe as possible during the insemination.

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