Intracytoplasmic sperm injection-This is a well established technique that enables an embryologist to manipulate both male and female gametes out side the body to maximize the probability of fertilization. This technique was initially developed for sever male factor indication where, it was not possible for the sperms to reach the egg on their own. Later on, this innovative procedure was also found to be effective in other indications like unexplained infertility, patients having Immunological factor, repeated failed IVF etc. Here, a morphologically normal sperm is selected and is injected into the centre of an egg. Whole procedure is closely monitored under inverted microscope at the magnification of about 400X.
Up to 40% of couples coming to infertility specialist have a male infertility problem relating to the number or quality of sperm produced. The intra-cytoplasmic sperm injection (ICSI) of eggs, introduced several years ago has revolutionised treatment for couples with male factor infertility. ICSI involves the injection of a single sperm into the cytoplasm of the egg. This is performed by the scientist in the laboratory at the fertilisation phase of a normal IVF cycle. No motility is required of the sperm used for ICSI, therefore it is the best fertilization method for very poor quality sperm and sperm retrieved from the testis and epididymis.
Today we are now finding that around 50% of couples having IVF treatment also require ICSI to maximise the number of eggs being fertilized and there chance of pregnancy.
ICSI is also indicated in patients with hard oolemma(hard outer layer of oocyte or egg) like in cases of PCOS
With ICSI around 95% of couples have at least one oocyte fertilised and receive an embryo transfer after the procedure. Studies reveal that ICSI cycles having up to two embryos transferred have yielded a pregnancy rate of around 46% in those aged up to 35 years, 33% in the age group 35 – 39 years and 10 to25% in those aged 40 and over.