Intracytoplasmic sperm injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is an additional step to IVF. ICSI is the process by which a single sperm is injected into an egg. The fertilised egg is then placed into the uterus. This method may be recommended for couples who are experiencing fertility difficulties due to sperm-related infertility problems or if IVF has previously resulted in eggs not fertilising.

If you are having trouble naturally conceiving and you have been told that you (or your partner) have a low sperm count, you may be a good candidate for intracytoplasmic sperm injection (ICSI). To determine whether this fertility treatment is right for you, speak with your doctor about your options.

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The ICSI Technique

Firstly, in ICSI, the egg and sperm are prepared separately. Then the egg is held in position by a pipette with gentle suction from a microinjector, with the polar body held away from the area to be injected. The embryologist then picks up the prepared sperm with a glass micropipette, pierces the shell of the egg and injects the sperm into the egg’s inner cytoplasm. The egg/sperm will then be placed in a culture medium, as normal, and checked the next day to see if it has fertilised. The egg and sperm are tiny and all this takes place using micromanipulators and a powerful microscope.

When to decide if ICSI is required?

Often the plan to use ICSI is made before the IVF cycle starts. A previous semen analysis will have identified the need for ICSI treatment. The final decision will almost always be reviewed by the embryologist when he or she sees the actual eggs and sperms on the day of the procedure. This sperm sample may be better than the semen analysis suggested, or it may be worse. Where possible we will always let nature take its course and let the sperms and eggs mix as naturally as possible without using ICSI.

Our Fertility Centres have an outstanding ICSI success rate

Our ICSI success rates are outstanding when compared to the national average. We advise that you read through our success rates pages and the HFEA website to get an idea of the different ways the statistics could be produced. Success rates vary according to age, health, and reason for infertility.

Our success rates are due to the expert care delivered by the team, ongoing monitoring and experienced healthcare professionals in fertility.

Are all the eggs injected and does injecting cause any damage?

After egg collection, the eggs are prepared and assessed by the Embryologist. Only mature eggs will be suitable for injection, and not all the eggs collected will have reached the required maturity. Usually we will be able to inject at least 80% of the eggs collected.

The process of injecting the sperm does damage a small number of eggs (<10%). The damage usually becomes evident either during or after the procedure. Any eggs that are damaged in this way will not be used in the treatment.

Usually approximately 65% of eggs will fertilise regardless of the quality or numbers of sperm present. The chance of achieving a pregnancy with ICSI is very similar to that with conventional IVF.