ICSI (Intra Cytoplasmic Sperm Injection)
If there is a question of the sperm's ability to
fertilize the egg, due to either a low sperm
count or poor quality of the sperm, that poses
no problem whatsoever. Intra-Cytoplasmic Sperm
Injection (ICSI) would be performed instead of
regular In Vitro Fertilization (IVF). With ICSI,
the eggs are retrieved the same as if you were
doing conventional IVF. However, the eggs and
the sperm are then fertilized in the laboratory,
by direct injection of a single sperm into each
egg. Three days later the resulting embryos are
simply placed into your uterus with no surgery,
just as with IVF. Extra embryos are frozen for
later attempts at pregnancy.
The availability of this Intra-Cytoplasmic Sperm
Injection, "ICSI" technique (which was developed
and perfected by the Brussels University and our
institution in St. Louis) means that men whose
sperm previously were too weak or too few to
fertilize in vitro (IVF), now have no problem
fertilizing their wife's eggs. The fertilization
rate per egg using ICSI is about 70% despite the
sperm being terrible, the fertilization rate per
infertile couple is over 99% if the wife has
adequate eggs, and the pregnancy rate per
treatment cycle is over 50%. This is not
significantly different from regular IVF with
normal sperm. This technique is very
cost-effective, and will give you the same high
chance for getting pregnant as any couple with
normal sperm.
ICSI can only be carried out on a mature egg.
Unfortunately egg maturity can only be truly
identified under the microscope and it is,
therefore, possible that following egg
collection, none of the eggs are suitable for
ICSI. This situation is normally rare, but it is
still a possibility.
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