Intracytoplasmic Sperm Injection (ICSI) in NYC
Over the past 25 years, micro-manipulation techniques have been developed using specially designed magnifying microscopes to perform highly delicate operations on sperm, egg cells, and embryos. Initially, these were used for:
- Intracytoplasmic sperm injection (ICSI), in which a single sperm cell is injected into each mature egg retrieved during IVF.
- Assisted hatching, when a tiny hole is made in the protective covering of each embryo before it is transferred to the uterus, in order to help the embryo attach itself to the uterine lining (embryo implantation).
Learn more about ICSI at our NYC fertility clinic below, or request an appointment today using the form on this page.
What’s involved with intracytoplasmic sperm injection (ICSI)?
This technique, perfected at the Free University of Belgium in the mid-1990s, revolutionized the treatment of male-factor infertility due to inadequate or deficient sperm cells. It involves microinjecting one sperm cell into each egg cell, resulting in a fertilization rate of 90-100% of all eggs inseminated in this way.
Up until then, eggs retrieved at IVF were fertilized by placing each egg in a culture dish containing 50,000-100,000 sperm cells per milliliter of culture fluid, and checking the next day if the egg had fertilized.
There were usually three outcomes:
- The egg did not fertilize at all, meaning not one sperm managed to penetrate into the egg
- The egg was successfully fertilized and showed two pro-nuclei in place of the single nucleus that the egg cell had
- More than one sperm had penetrated the egg resulting in more than two pro-nuclei – an abnormal result that would never prosper beyond its initial stage of polyspermia
The overall fertilization rate depended on the quality of the sperm – zero in some cases, but the average fertilization rate was 50-75%.
What are the advantages of intracytoplasmic sperm injection?
ICSI offers the following advantages:
- IVF can be performed even if there are literally only 10 sperm cells in the partner’s semen sample because only one sperm is needed for each egg.
- This is not possible with conventional IVF where an egg must be surrounded by at least 50,000 sperm cells in the hope that at least one cell will penetrate the egg.
- Because the sperm cell is directly injected into the egg, most of the factors that used to be required in an individual sperm cell so it can penetrate the egg and fertilize it, no longer seem to matter.
- As long as the sperm cell is alive, it becomes functional once it is inside the egg.
- It eliminates the problem of polyspermia, which in a way results in wasting an egg that could have fertilized properly with only one sperm, so more eggs are available for normal fertilization.
When is ICSI performed?
ICSI has become a routine procedure to treat infertility. Originally, ICSI was employed only for severe male factor cases – when the sperm count was very low, when the sperm do not move well or rapidly, and or when the partner’s sperm is known to have <14% normal morphology. ICSI is able to overcome all of those disadvantages.
Over the years, as embryologists developed skills at micro-manipulation of individual egg and sperm cells under a powerful magnifying microscope, IVF clinics have been using ICSI routinely for all patients to ensure a consistently high fertilization rate.
- The more eggs fertilized, the more embryos will develop.
- If the embryos all develop normally, there are more chances for pregnancy if the first embryo transfer fails.