ICSI was introduced as a clinical level improvement to conventional
IVF treatments. It involves carefully selecting only one single
sperm of the best quality for injection into an egg to achieve
fertilisation
This procedure is done using a high precision technique called
‘micromanipulation’. The resulting embryo is then transferred back
into the uterus to continue its development as with a normal
pregnancy.
ICSI is recommended when there is severe male factor infertility, including low sperm concentration, poor motility, blockages in the male reproductive tract or where there is a desire to get pregnant after having had a vasectomy. It may also be advised when the female has a very low yield of eggs during egg retrieval so as to directly improve the chances of fertilisation by clinical intervention. Your IVF London consultant may also recommend this enhanced procedure if a previous IVF treatment has resulted in a low fertilisation rate of eggs.
The woman will be required to undergo ovarian stimulation to prepare
her eggs for collection as in a traditional IVF treatment plan. The
sperm from the male partner will then be processed, washed and
inspected in our laboratory to select only one sperm which will then
be carefully injected into a retrieved egg. The aim is to inject the
most normal looking sperm with good progressive movement into each
mature egg. In cases of surgically retrieved sperm ICSI or IMSI may
be recommended to achieve fertilization.
Our embryologists will closely monitor the fertilization procedure
and the developing embryos in preparation for embryo transfer back
into the woman’s uterus. Any surplus good quality embryos can be
frozen for future use.
Similar to the ICSI procedure, this is an enhanced assessment of the sperm which uses a far greater magnifying power. By being able to select only the sperm without any morphological alterations called ‘vacuoles’ can increase the chances of successful fertilization and normal embryo development. It can also decrease any likelihood of miscarriage. IMSI has shown to improve chances of pregnancy in couples whereby the male has a high level of DNA fragmentation index in the sperm.
IMSI is recommended when there is severe male factor infertility including known morphology factors and also where previous ICSI treatment has been unsuccessful.
Similar to ICSI, the woman must first be stimulated with medications to prepare for an egg retrieval procedure. The ejaculated or surgically retrieved sperm is washed and prepared prior to conducting the IMSI procedure within our laboratory. Our embryologist will conduct an inspection and selection of one single sperm of the best quality using a high powered inverted microscope. Each mature egg is injected with a single best quality (non -vacuolated/least vacuolated) sperm to achieve fertilization.
Fertilisation rates following ICSI/IMSI can be high, but
unfortunately not all fertilised eggs will develop into healthy
embryos. Depending on the woman’s age, some of the eggs may be
abnormal and therefore fertilisation may result in an abnormal embryo
. It is rare that any eggs, sperm or resultant embryos are damaged in
the procedure although some of the eggs may be very fragile and may
not be able to sustain the micromanipulation procedure leading to
disintegration. The HFEA site also acknowledges that there may be a
risk of long term health issues for children conceived using IVF with
ICSI as the sperm used in the procedure may not have otherwise
fertilized an egg naturally, although, as yet, there is no conclusive
evidence.
It is important for you and your partner to discuss the ICSI risks
and benefits with our Consultant as they can provide information
that’s specific to your personal fertility history. By obtaining a
better understanding of ICSI risks and how they may impact you and
your family, can help you make an informed decision on whether or not
to pursue this particular course of fertility treatment.