Intracytoplasmic Sperm Injection With IVF
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Assisted Reproductive Technology
|What Is ICSI?
ICSI stands for intracytoplasmic sperm injection. It is where a single sperm is injected into a woman's egg under a microscope using a very fine needle (thinner than a hair). The procedure is sometimes used in combination with IVF (half of all IVF procedures use ICSI). Not all couples undergoing IVF need ICSI. If the man's sperm is healthy, it can be placed in a shallow plastic dish with his partner's egg and left to incubate and fertilize naturally. ICSI is usually used where the quality of the man's sperm is impaired and the only hope of it fertilizing an egg is if it is literally injected into it.
By having ICSI, it means that sperm do not have to swim to the egg or penetrate the outer layer of the egg. This can help couples where the man’s sperm:
The procedure is performed by a doctor called an embryologist. He removes layers from the woman's eggs and washes the sperm in a special solution. Then he sits down at a powerful microscope for an extremely delicate task. With one hand he holds an egg steady with a pipette (which causes suction), with the other he injects the sperm into the middle of the egg. Which sperm the embryologist chooses is another task in itself. He will choose the most 'active' looking one that is moving about. Sperm retrieved by sperm aspiration are notorious for not moving. He may add a chemical to the sperm to make them at least twitch, so he can pick out the liveliest looking one. Once the best looking sperm is chosen, it is sucked up with a needle and carefully injected into the egg. After this, the process continues as any normal IVF treatment would. The inseminated egg is incubated overnight with the hope that fertilization will occur. If the eggs do not fertilize they need to be discarded. ICSI cannot be repeated.
The average live birth rate resulting from ICSI and IVF is:
There are no side effects to the mother as fertilization happens in vitro (meaning out of the body). As ICSI is a relatively new procedure (since 1992), the long-term effects on a child conceived by this method are not yet known. It may be that injecting sperm into an egg could damage the egg. The risks associated so far include:-
How To Reduce The Risks
If you are considering ICSI it makes sense to talk to a genetic counselor about screening for possible genetic disorders before starting fertility treatment. If a genetic abnormality is identified your counselor will be able to advise you of the risks of passing this on to any children you have. He may for example recommend PDG testing - genetically testing embryos for disorders before implantation in the mother. Following a successful birth from ICSI, the parents should be offered newborn screening (see baby care after delivery).
The average cost of ICSI is $1,900. If the sperm needs to be surgically removed from the man, this costs a further $2,500. These fees are in addition to your regular IVF costs.
|Related Articles on ART Procedures
For more articles, see the following:
• Genetic testing during pregnancy: When it is recommended.
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