Intracytoplasmic Sperm Injection (ICSI)
This assisted reproductive technique was developed to help bypass the need for sperm to penetrate the shell of the egg (called the zona pellucida). The primary indication for ICSI includes male factor infertility, as it significantly improves fertilization rates. Threshold semen parameters at IVF Phoenix includes sperm concentration <5 million/mL, motility <5%, and largely abnormal shape of the sperm. It is also indicated for preimplantation genetic testing (PGT), to help reduce contamination from other sperm when performing the embryo biopsy for genetic evaluation (because conventional insemination can result in extra sperm attaching to the outer shell of the egg) as well as for fertilization of cryopreserved eggs, since the freeze-thaw cycle causes the shell to harden, making it difficult for sperm to penetrate.
After your egg retrieval, cells surrounding the eggs are carefully removed. Only mature eggs are selected are then selected for fertilization, and remaining immature eggs are cultured and examined for possible in vitro maturation and later fertilization. During the ICSI procedure, a single sperm is selected and immobilized by a micropipette. This injection pipette then pierces the egg at the 3 o’clock position. To facilitate this process, the egg is held in place by a holding pipette at the 9 o’clock position. The injection of sperm will then trigger oocyte activation and hopefully, fertilization. Activation of mature eggs after ICSI is 70% or more.
Based on older studies, ICSI may predispose to imprinting disorders (limiting expression of genes from one parental copy-either maternal or paternal), particularly Beckwith-Wiedemann syndrome, Angelman syndrome and maternal hypomethylation syndrome. More recent studies have failed to show this increased risk and the slightly increased is primarily attributed to infertility rather than ART techniques and the incidence of these disorders remains very rare (<1/12,000 births).
The remaining steps are similar to convention IVF.