ISIS Regional Fertility Centre

2180 Meadowvale Blvd.
Mississauga
Ontario L5N 5S3
Tel: 905-816-9822
Fax: 905-816-9833

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Intra-cytoplasmic Sperm Injection (ICSI)

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ICSI is a procedure used along with IVF. ICSI allows couples with severe male factor infertility to have genetically-related children.

The couples that will benefit most from ICSI are those with one or a combination of the following:

•  Low sperm count
•  Low sperm motility
•  A low percentage of normal-shaped sperm
   (low sperm morphology)

• Poor or failed fertilization in a previous IVF attempt
• High incidence of polyspermic fertilization in a previous IVF attempt

Since ICSI requires only one motile sperm per egg, many of these couples now have a realistic hope of conceiving and giving birth to their own biological offspring. Other potential candidates include patients with failed vasectomy reversals, varicocoele repairs and patients who have been unsuccessful in numerous previous intrauterine insemination cycles.

ICSI involves depositing a single sperm directly into the mature egg. Using a micromanipulation apparatus, a single suitable sperm is loaded into a small "injection pipette". With a second "holding pipette", the egg is held while the injection pipette is passed through the zona pellucida and egg cell membrane. Finally, the sperm is injected in a tiny volume of culture medium, the injection pipette is withdrawn and the egg is released.

Apart from the micromanipulation procedure and subtle differences in semen processing, all aspects of treatment are the same as those of routine IVF. Female patients receive the same hormone treatments and monitoring, egg retrievals and semen collection are scheduled using the same criteria, fertilization and embryo development are assessed and embryo transfers are carried out as in standard IVF procedures.

Fertilization rates of eggs with ICSI are 50-70% on average but may be higher.

The risks associated with ICSI are still inconclusive. This is because even though thousands of children have been conceived using ICSI, the numbers are still too small for conclusive results. ICSI was first developed and used in humans in 1992 so that first child in only now approaching an age when having a family may be considered. However, the evidence so far suggests that the fetal abnormality rate is only slightly increased over that of natuarally conceived pregnancies. It has been determined that there may be an increased risk of passing on genetics that lead to male factor infertility to sons.