Conventional in vitro fertilization (IVF) involves placement
of thousands of moving sperm with each egg in a culture dish.
During this stage of IVF, The sperm must penetrate the egg to cause fertilization.
IVF with ICSI is a mainstay of fertility treatments allowing men with little or no sperm in their ejaculate to father children. If
recognized circumstances predict failure of fertilization by
conventional IVF, then intracytoplasmic sperm injection (ICSI)
may be recommended. ICSI is an alternate means of fertilization
in which the spermatozoan (sperm) is manually placed inside the egg using micromanipulation tools.
ICSI is
performed at our Virginia fertility clinic with the aid of a special microscope fitted with
micromanipulators that are used to guide small glass micropipettes.
A blunt micropipette is used to cradle the egg while a sharp
micropipette is used to capture a single sperm and inject
it into the egg. Approximately 95% of mature eggs survive
the ICSI process.
ICSI is
most often recommended when evaluation of the semen reveals
abnormal low (or no) sperm count, motility, or morphology (shape) or
when fertilization was low or absent in a previous conventional IVF attempt. ICSI may also be appropriate for couples with unexplained infertility or when cryopreserved sperm specimens
are used. Sperm recovered surgically from the testis (testis
biopsy) require ICSI.
The health
of children born as a result of IVF with ICSI is a matter
of ongoing study. Some studies raise the possibility that
ICSI is associated with elevated risk of birth defects or
genetic problems compared to children conceived without ICSI.
ICSI began in 1992 and the children born from this treatment
have not yet reached adulthood and there is essentially no
information on their ability to reproduce. Additional research
will be required to fully address this important issue.
|
