ICSI – intracytoplasmic sperm injection is a refinement of the IVF technique. With ICSI a single sperm is directly injected into an egg, whilst in IVF thousands of sperm are mixed with a single egg with one of the sperm entering the egg without assistance
So IVF or ICSI? ICSI is not needed for every couple. It should be only be used when clinically indicated, as there are risks and complications to this technique. There is an extremely small increase in congenital problems in children who are conceived by ICSI.
ICSI is recommended for patients when there is an increased risk of fertilisation failure due to sperm disorders (such as very low sperm counts or motility), previously failed fertilisation with IVF or following Surgical Sperm Retrieval (SSR).
With ICSI, eggs are collected from the woman and sperm from the man in exactly the same way as for IVF. The best sperm are selected and a single sperm is injected with a tiny needle directly through the membranes into the egg to achieve fertilisation. If fertilisation occurs, the embryos are replaced as in standard IVF.
When there are no sperms found in the semen then sperm can be directly retrieved from the testicle and used for ICSI. This process is called Surgical Sperm Retrieval (SSR) and is normally performed before the female partner starts her stimulation drugs. Sperm retrieved by SSR are frozen and kept for treatment for up to 10 years.
IMSI (intra-cytoplasmic morphologically selected sperm injection) is a relatively recent development of ICSI. The main difference is that it is possible to improve the selection of sperm using much greater magnification. This technique comes at increased financial cost- the question is does it make a much greater improvement in live birth rates? This is unfortunately not yet conclusively known, but it is unlikely to make a difference to the majority of couples requiring ICSI
Fertility consultations including discussion of ICSI/ IMSI can be arranged via contacting my PA, Ms Yvonne Baillie on 0207 125 0547 or email her here