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For roughly half of all couples struggling to conceive naturally, the cause of infertility is sperm-related. Intracytoplasmic sperm injection (ICSI) is one of the most effective treatment options for male-factor infertility. What is ICSI? Who should use ICSI? And why might it be helpful to carry out alongside IVF? Let’s explore.
Intracytoplasmic sperm injection, or ICSI, is a technique used to aid couples trying to conceive. ICSI is one of the most powerful treatments available for male-factor infertility. It’s used alongside in vitro fertilization (IVF) treatment to improve success rates for many patients.
Simply put, the technique involves an injection of a single sperm into an egg (read on for an in-depth explanation of the ICSI process). ICSI has transformed male-factor infertility treatment because very few sperm are required, and the ability to reach and penetrate the egg is no longer a barrier to fertilization.
ICSI is a fertilization technique that can be used during IVF. Here’s what the ICSI procedure looks like, generally speaking:
Can ICSI be used with frozen sperm? Yes, and it’s a very effective combination.
Sperm freezing is the process of collecting sperm, usually via masturbation, and cryopreserving it. Sperm freezing is accomplished using liquid nitrogen and special slow-cooling techniques that minimizes damage to the sperm and allows it to be stored for long periods of time.
Sperm freezing is helpful if:
ICSI is equally effective, whether you use frozen or fresh sperm. In fact, ICSI can be a great way to maximize your chances of pregnancy with IVF if you have a limited quantity of frozen sperm. Read on to learn about ICSI success rates.
Legacy provides flexible sperm freezing options, at-home sample collection, and helpful payment plans. Find out more about sperm freezing.
ICSI is a specific technique used during in vitro fertilization (IVF). “In vitro” means “in glass,” and refers to the fact that the fertilization procedure is performed in a lab dish.
In conventional IVF, the egg and sperm are left in the dish to fertilize without any intervention. In this situation, many sperm are typically present in the sample and can swim to, penetrate, and fertilize the egg, just as would normally occur inside the fallopian tubes.
When using ICSI, a micro-needle is used to extract a single sperm cell, which is then directly injected into the cytoplasm of the egg. This bypasses the need for the sperm to move toward and enter the egg on its own. This can be especially helpful for those with low sperm count, poor morphology or motility, or limited available quantities of frozen sperm.
ICSI is particularly recommended for those with:
Emerging research also shows that ICSI may increase success rates with IVF for older couples, especially couples with a female partner over 35.
ICSI may be beneficial for people with fertility issues related to sperm health. In fact, ICSI has been used to achieve pregnancy even in very severe cases of male-factor infertility.
ICSI does not guarantee fertilization. On average, 60–80% of eggs injected during ICSI will fertilize.
ICSI may not increase success rates for those without specific male-factor infertility concerns. One study found that pregnancy rates were comparable for ICSI and conventional IVF cycles, when looking at patients with normal semen health.
However, for those with sperm health issues, ICSI may be effective. One small study found that, for couples who experienced fertilization failure during previous IVF cycles, using ICSI resulted in a 72% pregnancy rate. Another found that for patients with IVF failure related to low semen quality, ICSI was significantly more successful than conventional IVF.
While ICSI can help overcome issues of sperm count, morphology, or motility, it can’t change the genetic health of sperm. Sperm that have high levels of DNA fragmentation — AKA damage to the DNA inside sperm — may not result in a healthy embryo, even if fertilization is achieved. We highly recommend that couples considering ICSI or who have experienced IVF failure do a sperm DNA fragmentation analysis.
The act of injecting the sperm cell into the egg can result in damage to the egg, but around 90% of the eggs injected will survive.
ICSI costs anywhere between $800 and $2,500, depending on where you have the procedure performed and how many eggs are injected. It may be covered by insurance, if your plan also covers IVF treatment.
If you have concerns about your sperm health or if you have been struggling to conceive naturally, the first step is a semen analysis. This test will examine several sperm health parameters, such as sperm quantity quality, including sperm motility.
Couples who are planning to do IVF with ICSI should also consider sperm DNA fragmentation analysis. This test can assess the percentage of sperm that contain damaged DNA, which can be an obstacle to conceiving even with fertility treatment.
Thanks to at-home sperm testing kits from Legacy, semen analysis and DNA fragmentation analysis can both be done in the comfort of your own home.
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