Intracytoplasmic Sperm Injection

ICSI is the quick shape for intra-cytoplasmic sperm injection.


Sperm Injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is a specialised form of in-vitro fertilisation that is used for the treatment of severe cases of infertility. Healthcare providers most commonly use ICSI when the male-factor affects the ability to conceive a child. ICSI involves the direct injection of a single healthy sperm directly into a mature egg with the help of a micropipette, and once fertilisation occurs, the fertilised egg grows in a laboratory for 1 to 5 days before the embryo is transferred to the woman's uterus. Pregnancy occurs if the embryo attaches to the lining of your uterus. ICSI is a safe and effective procedure for couples with male factor infertility, and can improve the chance of fertilisation for couples with poor fertilisation success in a previous IVF cycle.

ICSI as Treatment

ICSI helps to overcome some fertility problems such as ;

  • Less quantity of sperm to do an IUI or IVF
  • Poor sperm morphology (abnormally shaped sperm)
  • Poor sperm motility (sperm does not move in a normal fashion)
  • Sperm may have trouble attaching to the egg
  • Blockage or obstruction in the male reproductive tract
  • Eggs not fertilised by traditional IVF, regardless of the condition of the sperm
  • Anejaculation (inability to ejaculate), and retrograde ejaculation (semen flows backward into the urinary bladder)
  • Anti-sperm antibodies (antibodies that are produced by the man's body and may inhibit sperm function)
  • In vitro matured eggs are being used
  • Previously frozen eggs are being used

How is it done?

The process of ICSI involves using a pipette to hold the mature egg in place on a lab dish. One sperm is immobilised and picked up using a thin needle. The needle is then inserted into the egg to reach the cytoplasm after which the sperm is injected and the needle withdrawn. After the sperm injection is done, the fertilised egg is monitored in the laboratory for signs of successful fertilisation. Within five to six days, a healthy and fertilised egg should divide into cells, forming a blastocyst. An embryo transfer occurs on either the fifth or sixth day following the egg retrieval procedure (or next month in case of embryo freezing), and this is identified using an endometrial receptivity array. Using ultrasound technology, a catheter is then inserted into the vagina and the embryo is injected or placed in the uterus. For pregnancy to occur, the embryo needs to attach or implant onto the uterus. It is recommended to wait at least two weeks before taking a pregnancy test.

Although ICSI is a fairly successful procedure, there may arise some complications in the procedure, which include

  • Damage to some or all of the eggs during needle penetration
  • Egg does not fertilise after the sperm injection
  • Embryo stops developing in the lab or after embryo transfer

This method usually results in normal fertilisation in about 75-85% of cases.