ICSI or Intracytoplasmic sperm injection

ICSI

The pursuit of pregnancy can be harrowing. The emotional and financial costs are significant.

Male infertility (MI) is a complex multi factorial disease, and idiopathic infertility (unknown cause)accounts for 30% of cases of MI.

The purpose here is to provide you with greater detail on, in this case, ICSI (Intracytoplasmic sperm injection).

Intracytoplasmic sperm injection (ICSI), where the sperm is injected directly into the ovum, was introduced in 1992.

To improve fertilization in couples with male factor infertility undergoing in-vitro fertilization (IVF), or in couples with fertilization failure in a prior IVF cycle without detectable abnormalities of semen .

Although the diagnostic criteria used to identify male factor infertility fail to predict with perfect accuracy poor or absent fertilization in assisted reproductive technology (ART), studies to date support the safety and efficacy of ICSI to treat various male factor conditions.

The use of ICSI for patients with borderline or even normal semen has become more common.

This committee opinion provides a critical review of the literature, where available, to identify situations where this may or may not be of benefit.

Again, it is about making informed choices

Summary

ICSI for unexplained infertility has been associated with increased fertilization rates and decreased risk of failed fertilization in some studies but has not been shown to improve live-birth outcomes.

There are no studies addressing whether ICSI of poor-quality oocytes improves live-birth rates.

ICSI for low oocyte (a cell in the ovary that can become the ovum), and advanced maternal age does not improve live-birth outcomes.

ICSI can increase fertilization rates when lower than expected or failed fertilization has previously occurred with conventional insemination.

In cases without male factor infertility or a history of prior fertilization failure, the routine use of ICSI for all oocytes is not supported by the available evidence.

ICSI for PGT in the absence of male factor infertility should be limited to cases where contamination of extraneous sperm could affect the accuracy of test results.

ICSI appears to improve fertilization rates of in-vitro matured (IVM) oocytes although implantation and clinical pregnancy rates appear higher in IVM oocytes inseminated conventionally.

Caution should be exercised in the interpretation of these data due to the lack of data on live-birth rates.

ICSI on cryopreserved (frozen) oocytes is the preferred method for achieving fertilization, although limited data currently exist to support this procedure.

When considering use of ICSI in non–male factor infertility to decrease the incidence of unexpected failed fertilization, prevention of one case of unexpected fertilization failure requires more than 30 unnecessary cases of ICSI.

Conclusions

ICSI without male factor infertility may be of benefit for select patients undergoing IVF with preimplantation genetic testing for genetic disease and previously frozen oocytes.

The additional cost burden of ICSI for non–male factor indications, where data on improved live-birth outcomes over conventional insemination are limited or absent, must be considered.

If there is no problem with the sperm, then ICSI probably is not what you need.

Speak with a qualified Chinese Medicine Practitioner

Research is ongoing

Herbal remedies have been found to promote spermatogenesis by optimizing semen parameters, sex hormone levels, and antioxidant profiles.

As a result, these treatments should be regarded as complementary approaches to male infertility.

Information re ICSI has been reproduced from fertility and Sterility

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