What is ICSI?
If you have low sperm numbers or poor sperm motility or morphology, it’s possible your Fertility Specialist will recommend a type of IVF treatment called ICSI or intracytoplasmic sperm injection. ICSI may also be recommended if you have previously had a vasectomy and an unsuccessful vasectomy reversal.
ICSI is similar to IVF but in this type of treatment the sperm is not left to penetrate the egg in the dish, instead our scientists carefully inject a single sperm directly into the egg. We develop any resulting embryos in our world leading incubation system, Geri, for several days before we transfer one embryo into the woman’s uterus.
Where male infertility is the cause behind a couple struggling to conceive, ICSI is likely to be part of the treatment protocol suggested by your doctor. It’s important to ensure that ICSI is the right treatment choice and that it addresses your specific infertility issue. Selecting the right clinic for fertility treatment is vital. Getting the right diagnosis is crucial so starting with a clinic that offers a range of treatments means your Fertility Specialist will investigate your personal situation and prescribe the right treatment approach to help you start or grow your family.
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In a woman’s ovaries follicles begin developing every month. Each menstrual cycle, approximately one to 30 follicles will grow – the exact number depends on a woman’s age and ovarian reserve. As the cycle progresses, just one of those follicles will become dominant and release a mature egg.
During an ICSI cycle, much like in an IVF cycle, we use injections of a hormone known as FSH (follicle stimulating hormone) to encourage more of the follicles to develop mature eggs. These eggs are then collected under vaginal ultrasound guidance – called oocyte (egg) pick up (OPU) or oocyte retrieval. It’s a day surgery procedure which is usually done with a local anaesthetic and light sedation.
The male partner’s semen sample is prepared in Genea’s Andrology lab to find and isolate as many healthy, moving sperm as possible. Genea’s embryologists also prepare the eggs, removing the tight outer coating of cells to assess their maturity and ease the way for fertilisation.
Once everything is prepared, an embryologist uses a special needle-like instrument to pick up a single sperm and another instrument to hold the egg in place. All of this is done under the power of a microscope as sperm are so small they can’t be seen with the naked eye. The needle carrying the sperm is inserted through the egg’s outer coating and into the egg itself. The sperm is slowly injected into the egg. We develop the injected eggs in an incubator overnight and the next morning your scientist will check for signs of fertilisation. Another 24 hours, your scientist can determine how many eggs have gone on to form embryos. The developing embryos are monitored for several days, in Genea’s exclusive Geri™ incubation system
before one is transferred to the uterus. Patients are able to watch their embryos develop in Geri via our Grow By Genea® app
. If there are additional embryos, they can be frozen and stored for later use.
Not all eggs fertilise, and not all fertilised eggs become embryos.
Physiological Intracytoplasmic Sperm Injection (PICSI) is another version of ICSI treatment which adds a functional test for sperm into the process. This test helps our andrologists select the best sperm and it is based on a sperm’s ability to bind to an acid called Hyaluron, mimicking the natural binding of mature sperm to eggs.
This form of ICSI is sometimes used for patients who have experienced poor fertilisation rates in previous cycles or poor embryo development. Other patients who might be recommended to try PICSI include those with high levels of sperm DNA fragmentation.