ICSI (Intra Cytoplasmic Sperm Injection)
- Intra Cytoplasmic Sperm Injection or ICSI involves injecting a single sperm directly into the centre of egg, whereas in standard IVF egg/eggs are mixed with thousands o9f sperm in a dish for fertilization.
- ICSI involves the use of specialized micro manipulation tools and equipments and specialized inverted microscope that enables embryologists to select and pick up one good looking sperm in a specially designed ICSI needle.
- The needle is carefully advanced through the outer shell of the egg and the egg membrane and the sperm is injected into the inner part (cytoplasm) of the egg.
- This usually result in fertilization of about 80 to 85% of eggs with sperm.
- However , as in standard IVF procedure , first the woman must be stimulated with hormone injections and then undergo an egg retrieval procedure (pick up) to obtain several eggs for ICSI.
- The technique was developed G. Palermo in 1991 at The University Of Brussel, Belgium. First IHR’s ICSI baby was born in 1995.
WHO SHOULD BE TREATED WITH ICSI ?
ICSI is considered absolutely in case of severe male factor infertility such as :
- Low sperm count : Sperm concentrations of less than 15-20Million per milliliter.
- Low sperm motality : Less than 35%.
- Very poor sperm morphology : Less than 4%
- Having previous IVF with no fertilization or low rate of fertilization (Low percentage of mature eggs that were normally fertilized)
- Some ICSI is used for couples that have a low yield of eggs at egg pick up procedure. ICSI is being used to try get higher percentage of eggs fertilized than with conventional insemination of the eggs ( mixing eggs and sperm together).
TESE AND ICSI
- Testicular Sperm Extraction (TESE) is the process of removing a small portion of tissue from the testicle under local anaesthesia or general anaesthesia.
- Few viable sperm cells are extracted from that sample of tissue. ICSI is performed from these sperm cells.
- TESE and ICSI is recommended to men who :
1. Cannot produce sperm by ejaculation
2. Have AZOOSPERMIA
- Intra Cytoplasmic Sperm Injection (ICSI) and Testicular Sperm Extraction (TESE) have reduced the need for donor sperm.