The ICSI technique, pronounced (ick-see), was developed by an IVF center in Belgium and they reported the first successful pregnancies using ICSI in 1992. Our embryology team has been performing ICSI since 1994. ICSI involves inserting one sperm directly into an egg using micromanipulation instruments. It is used as an alternative to conventional insemination of eggs (in which sperm are placed in the same drop with an egg and fertilization is allowed to proceed unassisted) during an IVF cycle. ICSI is performed when there is information suggesting that conventional insemination may fail, resulting in no fertilized eggs, and subsequently, no embryos available for transfer into the uterus.

How it is done?

ICSI is performed after the eggs have been retrieved during an IVF stimulation cycle. After retrieval, the eggs are cleaned to remove all of the cells that are found around the egg. Each egg is then injected individually. One egg is placed in a drop of media and held steadily on a small suction pi-pette. One sperm is then gently inserted into the egg using a very small needle. At the conclusion of the procedure the egg is returned to a culture dish and placed in the laboratory incubator.

Who is a candidate?

We recommend that patients have ICSI when they have had a previous IVF cycle with poor or no fertilization (less than 30% of the eggs fertilized when conventionally inseminated), or when semen parameters have been abnormal on at least one previous semen analysis. ICSI would be recommended when male factor is suggested which includes one or more of the following semen pa-rameters: sperm counts less than 20 million per ml, sperm motility of less than 50%, sperm morphology of 6% or less during a Kruger analysis, or antisperm antibody levels greater than 50%. These parame-ters were established based on experience in our lab with IVF cycles in which there was little or no fertili-zation, and on data reported in the IVF literature.

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