HRCL

Infertility

Intra-uterine Insemination

IVF

ICSI

The Possibility of Success

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ICSI (Intracytoplasmic sperm injection) 

The most common indications of ICSI are the cases of male factor problems where the quality and/or quantity is/are not adequate. The procedure consists in the injection of a spermatozoid in the egg. This technique is relatively recent, and it has really helped couples where the man has severe alterations. Men with this kind of problem used to recur to sperm donation, but today they can have their cells colleted even directly from their testicles. 

This technique uses modern microscopes where the egg is kept by suction in the end of a thin tube, and the embryologist put a spermatozoid inside the egg. He does this using a needle seven times thinner than a human hair. The chance of fertilization is between 60-70%, and three days after this, the embryo is transferred to the mother’s uterus. 

The ICSI has been used in cases where patients were vasectomized or have any kind of obstruction to the spermatozoids. 

Spermatozoids Obtainment Without Reverted Surgery 

There are two techniques - Microsurgical epididymal sperm (MESA) and Testicular sperm extraction (TESE). The retrieved isolated spermatozoids are used to fertilize the eggs through ICSI.

While the intra-uterus insemination needs over 3 million spermatozoids class 3, the conventional IVF around 1 million, the ICSI needs only 3-4 spermatozoids to try a pregnancy.

The use of ICSI just differs from the conventional IVF in one aspect: While the spermatozoid penetration in the egg happens naturally in the IVF, in ICSI technique the spermatozoid is injected in the egg.

Recently the ICSI shows two great uses: To treat infertility caused by severe/moderate male factor problems and those patients that did not have pregnancy using the conventional IVF. The use of micromanipulator is also used in genetics studies of the embryos, allowing embrionary biopsies. 

It is becoming higher and higher the number of men that want to be fathers again. The factors can be a second wedding, widowhood, a premature lost of a child, and others. 

The great majority is composed by individuals that were submitted to methods of sterilization, such as vasectomy done a long time ago with/without previous attempt of failed reversion, or individuals that have developed a clear Immunologic factor due to the surgery. 

The vasectomized men from long date have lower chance of success with the vasectomy reversal surgery. In this situation the number and quality of spermatozoids obtained with the reversion are inadequate. In other situations the individual does not want to do the vasectomy reversal surgery, but still want to be a father. In that case the ICSI is the primary solution. 

ICSI Indications

•   Severe male factor problem (oligozoospermia and severe asthenozoospermia)

•   Azoospermia (total absence of spermatozoids)

•  Post-vasectomy 

•  Imunological factor 

• Fail in the fertilization (using the conventional IVF)