What is ICSI?

If you’ve been researching fertility treatments, you’ve probably come across the terms IVF (in vitro fertilization) and ICSI (intracytoplasmic sperm injection). Both play an important role in helping patients conceive, but it’s not always clear when or why ICSI is recommended as part of an IVF cycle. In this post, we’ll break down how each process works, when ICSI is used, and what you can expect from each option. 

What is IVF?

IVF starts with stimulating your ovaries to produce multiple eggs, which are then removed for fertilization by your Reproductive Endocrinologist during an egg retrieval procedure. After the eggs are collected, they are fertilized with sperm in a lab. Once fertilization occurs, the embryos are monitored for several days to assess their development. Then, one embryo (or in some cases, a few) is transferred into the uterus or frozen for future use.

In a typical IVF procedure, sperm is combined with eggs in a dish, and the fertilization happens without additional assistance. However, sometimes fertilization requires an extra step to increase the chances of success, and that’s where ICSI comes into play.

What is ICSI?

ICSI (intracytoplasmic sperm injection) is a specialized procedure that can be used during IVF to improve the chances of fertilization. While in traditional IVF, the sperm and egg meet in the petri dish, ICSI involves injecting a single sperm directly into the egg. This technique is useful for couples who have experienced challenges with fertilization in the past or when certain factors make natural fertilization more difficult.

Once eggs are retrieved during IVF, an embryologist will select a single sperm from the provided sample of sperm. Using a tiny needle, the embryologist injects the sperm into the egg. This precise process can increase the chances of a successful fertilization.

When is ICSI Recommended?

While IVF is a powerful fertility treatment, there are times when ICSI is recommended to give the fertilization process an extra boost. Here are some common reasons why ICSI might be used:

1. Issues with Sperm Quality: If you or your partner’s sperm sample has a lower count, reduced movement, or an unusual shape, ICSI makes it more likely that a healthy sperm will successfully fertilize the egg.
2. Previous Difficulty with Fertilization in IVF: If an earlier IVF cycle didn’t result in fertilization, your doctor might suggest using ICSI in future cycles. 
3. Use of Frozen Sperm: When frozen sperm is used (for example, if your partner stored sperm before a medical treatment), the movement of the sperm may be affected after thawing. ICSI ensures that a single sperm is placed directly into the egg, avoiding any issues with limited sperm motility impacting the chances of successful fertilization.
4. Surgical Sperm Extraction: In situations where sperm is surgically extracted from you or your partner (such as after a vasectomy or due to a blockage), ICSI might be recommended.

Success Rates with ICSI

ICSI has significantly increased the chances of successful fertilization for many couples. While traditional IVF results in fertilization in about 40-60% of cases, ICSI can achieve fertilization rates of 70-80%. It’s important to remember that while ICSI increases the chances of fertilization, it doesn’t guarantee pregnancy. A successful pregnancy still depends on factors like the health of the embryos, age, and other individual conditions.

Risks of ICSI

As with any medical procedure, ICSI comes with some risks, though they are generally minimal. The procedure itself doesn’t increase the risk of health issues in babies compared to traditional IVF. Most babies born through ICSI are completely healthy. However, there’s a small risk of damaging the egg during the injection process, but this is rare. Your Reproductive Endocrinologist will discuss any potential risks with you to ensure you’re making the best decision for your unique situation.

Choosing Between IVF and ICSI

For many couples, the choice between IVF and ICSI depends on their unique situation. If there are challenges related to sperm quality or if previous IVF cycles haven’t resulted in fertilization, ICSI may be the right option to consider. By using this advanced technique, many couples are able to achieve fertilization and move one step closer to pregnancy. However, ICSI will likely increase the overall cost of your IVF cycle, which might be a consideration. 

Your Reproductive Endocrinologist will help guide you through this decision. They’ll take into account your medical history, test results, and any previous fertility treatments you’ve undergone. Their goal is to tailor a plan that gives you the best chance of success, whether that involves traditional IVF or ICSI.