In 1992, a new reproductive technique was developed that was considered a breakthrough for helping many infertile men have children. Intracytoplasmic sperm injection (ICSI) uses micromanipulation technology to help men who have low sperm counts, a complete absence of sperm in their semen, a damaged or absent vas deferens, an irreversible vasectomy or any other problem causing infertility fertilize an egg.
ICSI is a technique whereby microscopic instruments are used to retrieve sperm directly from the testicles. If it is possible, though, the male provides a semen sample. However, the technique is always paired with in vitro fertilization. A woman will be given medication to help stimulate ovulation and the development of egg follicles. These mature eggs will then be retrieved and fertilized with her partner’s sperm.
During ICSI, a single retrieved sperm is drawn into a needle and directly injected into a harvested egg. As with the natural fertilization process, the egg will reseal itself after the needle has been withdrawn. The egg is now fertilized and will be left to develop for a few days before being transferred back to the woman’s uterus.
Success With ICSI
While ICSI so far seems to be the most successful treatment for men with fertility problems, the effectiveness of the technique depends upon the quality of the sperm. Even when a fertilized egg develops properly and is able to be transferred back to the women, it does not guarantee that the egg will implant itself into the uterine lining. Despite this, between 20% and 25% of couples undergoing ICSI and IVF treatment will have a live birth.
Too Good To Be True?
Although many in the medical world have hailed ICSI as a phenomenal advancement in the treatment of male infertility, there are some down sides to the technology. First, it is a relatively new procedure. As such, there is concern that children conceived through ICSI may experience more development or physical problems. Adding fuel to the fire is the fact that this technique allows any sperm to fertilize an egg, not just the strongest. Therefore, there is the possibility that congenital defects may also be passed on at a greater rate.
Since ICSI is used with IVF, there is also a better chance of a multiple pregnancy resulting along with an increased risk of an ectopic pregnancy.
The cost of ICSI may also prevent some people from using the technology. Like IVF, ICSI can range in price from $10,000 to $17,000.
Revision date: July 5, 2011
Last revised: by Janet A. Staessen, MD, PhD