ICSI
In standard IVF, eggs and sperm are placed together and fertilisation is left to happen. In ICSI, one sperm is injected directly into each egg. It exists for male factor infertility, where too few sperm reach or penetrate the egg on their own.
- One sperm injected into each egg
- For male factor infertility
- Same cycle as IVF otherwise
- Surgical sperm retrieval where needed
Stay
Day care for egg collection
Duration
One cycle, about three weeks
Anaesthesia
Sedation for egg collection
About ICSI
The stimulation, monitoring and egg collection are identical to IVF. The difference is in the laboratory: an embryologist selects a single sperm and injects it into the egg using micromanipulation. This overcomes low counts, poor motility and abnormal shape, and can be used with sperm retrieved surgically where there is none in the ejaculate.
- Identical to IVF apart from the fertilisation step
- Overcomes low count, poor motility and abnormal shape
- Can use surgically retrieved sperm
- Does not improve results where sperm is normal
Before you read on
Everything here is general information about icsi. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest icsi.
- Low sperm count, motility or abnormal morphology
- Previous IVF cycle with poor or failed fertilisation
- Sperm retrieved surgically from the testis or epididymis
- Frozen sperm samples of limited quantity
- Where sperm antibodies are present
- Couples using frozen eggs
Procedure details
The usual sequence, from first consultation through to follow-up.
Stimulation and monitoring
Injections stimulate multiple follicles, tracked by ultrasound and blood tests over about ten to twelve days.
Egg collection
Eggs are collected under sedation with ultrasound guidance, taking about twenty minutes.
Injection
An embryologist selects a single sperm for each mature egg and injects it directly using micromanipulation equipment.
Culture and transfer
Fertilised eggs are cultured for two to five days, and the best embryo transferred, with the remainder frozen.
How to prepare
What to sort out before you come in.
- A recent semen analysis is needed to confirm ICSI is the right approach
- Where sperm must be retrieved surgically, that is arranged in advance or on the day
- Both partners complete consent forms before the cycle begins
- Costs, including freezing, are set out in writing beforehand
- Folic acid and lifestyle measures should start before the cycle
Recovery
What to expect afterwards, and roughly when.
- Egg collection causes cramping and light bleeding for a day or two
- Report severe pain, marked bloating or breathlessness, which suggest overstimulation
- Embryo transfer is quick, needs no anaesthetic, and normal activity resumes the same day
- A pregnancy test is done about two weeks after transfer
- Where fertilisation fails, the reasons are reviewed before another cycle
Why choose Humayun for ICSI
ICSI is a laboratory technique, so the embryology laboratory is what actually determines the result.
- Micromanipulation equipment and trained embryologists on site
- ICSI used where male factor warrants it rather than applied to every cycle
- Surgical sperm retrieval available where there is no sperm in the ejaculate
- Costs, including freezing and storage, stated in writing before the cycle starts
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More in Fertility & IVF
IVF (In Vitro Fertilisation)
Fertilisation carried out in our in-house embryology laboratory, followed by embryo transfer.
IUI (Intrauterine Insemination)
Prepared sperm placed directly into the uterus around ovulation - a simpler first step than IVF.
Fertility Assessment
Investigation of both partners to establish why conception has not happened, before any treatment is recommended.
Ovulation Induction
Medication to stimulate the ovaries to release an egg, for women who ovulate irregularly or not at all.
Embryo Culture
The days in the laboratory between fertilisation and transfer, where embryos are grown and assessed.
Blastocyst Culture
Growing embryos to day five before transfer, which allows the strongest to be identified more reliably.
Embryo Transfer
Placing the embryo into the uterus, a brief outpatient procedure needing no anaesthetic.
Male Infertility Assessment
Investigation of the male partner, which is involved in roughly half of couples and is frequently skipped.
Semen Analysis
Laboratory assessment of sperm count, movement and shape, the first and most useful test in male fertility.
Fertility Counselling
Support through the emotional and practical side of fertility treatment, which most couples find harder than the medicine.