IVF with ICSI Treatment
Even with the latest IVF laboratory improvements, if there is a “sperm factor”causing infertility, you need Intracytoplasmic sperm injection (ICSI). In ICSI we selecting the best sperm and injecting each egg directly with a single sperm. ICSI is used in conjunction with IVF and the bulk of the procedure is exactly the same as discussed on our IVF page. ICSI is of special relevance when the sperm has to be aspirated from a blocked vas (tube that carries sperm from testes to penis) or directly from the testes. Frozen eggs need ICSI to fertilise them.
When do we need ICSI?
ICSI can be used to overcome a wide range of male fertility problems, even in cases where there are only a few suitable sperm produced. It can be used in cases of:
Low sperm count – when the sperm count Is so low that normal IVF may not ensure fertilisation of the egg
Low sperm mobility – removing the need for the sperm to reach the egg
Damaged sperm – choosing the very best, healthiest sperm for fertilisation
Obstructed sperm passage – due to physical issues, disease or even prior vasectomy
Ejaculation issues – including retrograde ejaculation and severe erectile dysfunction
How is ICSI performed?
Where possible, sperm is collected from a sample produced by masturbation in the clinic. Where this is not possible, sperm may be harvested direct from the epididymis, or the testes using simple surgical procedures such as TESA, MESA and PISA, conducted under general anaesthetic. Other harvesting methods include electro-ejaculation, which artificially stimulates ejaculation, or harvesting from the urine in the case of retrograde ejaculation.
ICSI is a “regulated” activity and will be performed at the primary HFEA licensed centre: IVF London (HFEA centre number 0365). All consultations and scans, on the other hand, can happen at our clinic nearest to you.
Is ICSI for us?
Although egg fertilisation rates are very high with ICSI, the subsequent implantation rate, and successful conception rate, is around the same as it is for unassisted IVF where sperm are left to combine naturally with the eggs (see IVF page for details). There are, therefore, no advantages to including ICSI in the treatment programme if you can produce high quantities of good quality sperm. However it can make a significant difference for couples who struggle to do so.
