Intra-cytoplasmic sperm injection (ICSI) is an alternative method of artificial insemination to in vitro fertilisation (IVF). With ICSI, the embryologist selects a single sperm to be directly injected into an egg, instead of fertilisation taking place in a dish where dozens of sperm are placed near an egg. It’s the most successful form of treatment in situations where the man has fertility issues and it’s used in nearly half of all IVF treatments.

ICSI treatment may be offered for a number of reasons, for example, if you have a very low sperm count, you’ve failed previous attempts at IVF, you’re using frozen sperm, or you need sperm to be collected surgically from the testicles.

How is ICSI carried out?

Prior to the treatment, you’ll need to complete various consent forms and you and your partner, if applicable, may need a few blood tests to screen for things like hepatitis B or C and HIV.

Treatment then typically involves the following:

  • As with IVF treatment, fertility medication will be needed to stimulate the woman’s ovaries to produce several mature eggs for fertilisation.
  • Your doctor will use ultrasounds to monitor this stage of the treatment. When the eggs are ready for collection, you and your partner will undergo separate procedures.
  • You’ll be asked for a sperm sample on the same day that the eggs are collected. Each egg is injected with a single sperm. If fertilisation takes place, the embryos will be cultured in the laboratory for up to six days and the best quality embryos will be transferred to the womb.
  • The clinic will recommend a single embryo transfer, as the likelihood of having twins or triplets increasses if more than one embryo is transferred.
  • Like IVF, your doctor will transfer embryos into the womb by using a fine catheter usually guided by ultrasound.
  • If you’re over the age of 40, two embryos might be transferred for a more successful chance of conceiving.

How long does ICSI treatment last?

One cycle of ICSI takes between four and six weeks to complete. You and your partner can expect to spend half a day at the clinic for the egg and sperm collection process. All being well, you’ll be asked to return two to five days later for the embryo transfer procedure.

What are the success rates of ICSI?

The fertilisation rate for ICSI may be higher than if you use IVF treatment; the pregnancy rate is the same as IVF pregnancy rates:

  • 44% if you’re 18-34
  • 39% if you’re 35-37
  • 30% if you’re 38-39
  • 21% if you’re 40-42
  • 11% if you’re 43-44
  • 2% if you’re 45 or over

Advantages of ICSI

  • ICSI might give you and your partner a better chance of conceiving your genetic child when other fertility options are unlikely to do so.
  • It can be helpful for couples struggling with unexplained infertility.
  • If there’s a problem with ejaculation on the day of egg collection then sperm can be extracted instead.

To find out more information about ICSI and other common fertility terms or abbreviations, check out our Jargon Buster.

 
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Andrew Drakeley

Mr Andrew Drakeley is the Clinical Director at the Hewitt Fertility Centre, working principally at the Liverpool Women’s site but with managerial responsibility for Knutsford.

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