What is ICSI?

A lot of terms associated with infertility and its treatment are a bit long and complicated, but the procedures associated with those terms aren’t as complex as one might think at first glance.

Consider ICSI, for example. Those four letters are an abbreviation for Intracytoplasmic sperm injection, a procedure that involves the direct injection of sperm into eggs obtained from the woman who is undergoing assisted reproductive technology.

Commonly referred to by its initials, ICSI is recommended in certain cases, including when male infertility is a major factor.

How does this work?

When a couple is undergoing assisted reproductive technology, there are two ways in which the retrieved eggs can be fertilized. The first is by IVF or in-vitro fertilization. For that procedure, thousands of sperm are added to each egg in hopes that one of those sperm will fertilize the egg.

In ICSI, only a single sperm is selected for injecting into the egg.

This is done by means of very advanced technology in which a very thin hollow needle is used to immobilize and pick up a single sperm, which is then injected into the cytoplasm of the egg.

A few days later, an embryologist will check the egg and see if it has been fertilized. If it has, it will then be implanted into the uterus.

Sometimes this is done with more than one egg so any others that were fertilized may be frozen for later use, if desired.

Why ICSI instead of IVF?

ICSI was developed in the 1990s and has been used since then to address mostly male factor infertility. Male infertility factors can include low sperm counts, poor motility or movement of the sperm, poor sperm quality, sperm that lack the ability to penetrate an egg, or a condition known as azoospermia.

Azoospermia means there is no sperm in the male’s ejaculation. That may be caused by scarring from infections, a previous vasectomy, or congenital absence of the vas deferens.

Is one procedure better than the other? Not necessarily. An abundance of research shows that when used for reasons other than male factor infertility, ICSI doesn’t provide a greater chance of having a baby. Those with other infertility issues can be just as successful with standard IVF procedures.

Are there any concerns with using ICSI?

The Practice Committee of the American Society of Reproductive Medicine has said it considers ICSI a “safe and effective therapy for male factor infertility.”

They also added, however, that it may carry “an increased risk for the transmission of selected genetic abnormalities to offspring, either through the procedure itself or through the increased inherent risk of such abnormalities in parents undergoing the procedure.”

In other words, those conditions may simply be hereditary. Other studies, however, have indicated contradictory results and do not concur with those findings.

As with any infertility procedure, it’s best to discuss all the options with an infertility specialist before deciding upon the best course of action.