INTRACYTOPLASMIC SPERM INJECTION (ICSI)

ICSI is a technique which helps couples undergoing IVF to enhance fertilisation of the retrieved eggs.

Introduced in 1992, it is now a routine procedure in most established IVF centres all round the world. Thousands of children around the world have been born using this technique. If ICSI is needed, you will be counselled by our staff and a joint decision will be made before proceeding.

The following information is helpful for couples wanting to find out more about ICSI.

What is ICSI?

ICSI is an invasive procedure where a single sperm is selected and directly injected into the egg crossing the egg shell (zona pellucida) and the oolemma (the outer membrane of the egg) in order to enhance fertilisation.

What are the benefits of ICSI?

ICSI helps to achieve fertilisation in patients with low sperm count or poor sperm motility and morphology (i.e. testicular sperm). It is also recommended for those patients who have defective egg shells, preventing the sperm from entering the egg; or for those who have a history of proven unsuccessful fertilisation with conventional IVF . When there is no fertilisation, it means the sperm is unable to achieve fertilisation on its own.

Is there a difference in pregnancy outcomes with ICSI or IVF?

The pregnancy outcome after ICSI is similar to that of IVF. Studies show no greater miscarriage, stillbirth or pre-natal death rates among the ICSI pregnancies.

Is there any risk of abnormality in children conceived using this procedure?

Studies have shown that there is no major difference between the children born by IVF and ICSI. The small risk of foetal abnormalities may also occur with normal pregnancies. There could also be other risks not associated with the procedure itself; such as the sperm carrying chromosomal anomaly and transmission of a genetic defect.

Why would I need ICSI?

Unsuccessful fertilisation could be due to a problem of the egg, sperm or sometimes both. To a large extent, ICSI helps to overcome this problem. ICSI could be helpful for you when you have:

(a) very low sperm count

(b) very low sperm motility

(c) sperm surgically retrieved from testis or epididymis, which do not have the capacity to penetrate the egg shell and fertilise

(d) prior failed cycles due to poor or no fertilisation

(e) very few eggs retrieved

Can ICSI be done for all my eggs?

ICSI can be done for all your eggs. However, if you have a large number of eggs retrieved, the eggs can be split into two groups. Conventional IVF and ICSI can be done separately after discussion with you and your partner if you have a history of unexplained fertility conditions.

Is there any difference in the day of embryo transfer procedure for embryos that have gone through ICSI?

There is no difference in the embryo transfer procedure or the day of embryo transfer regardless of whether your embryos have gone through ICSI or IVF. The embryos are gently placed in the uterus using a thin tube. This is usually a painless procedure lasting only about five to 10 minutes.

Is consent for doing ICSI on eggs needed

Prior written consent by both partners will be required if you wish for ICSI to be performed.

How is ICSI done?

In ICSI, a single sperm is injected into each egg using micromanipulation under an inverted microscope. This is a highly-sophisticated procedure requiring special skills and equipment.

Will ICSI procedure cause any damage to my eggs?

Damage due to the procedure itself is almost nil in skilful hands. However, as ICSI is an invasive procedure, there will still be a small amount of risk of damage to the eggs.

Is treatment required before and after transfer of embryos that have undergone ICSI different from routine embryo transfer?

No, there is no difference in treatment compared to routine IVF and embryo transfer. You will be given the same hormone injections as for IVF before egg retrieval. Hormone injections to support the lining of the uterus will also be given as after routine embryo transfer.

What is the success rate of ICSI?

ICSI offers a fertilisation rate of 60 to 70 per cent. Once fertilisation is achieved, the pregnancy rate is the same as conventional IVF. That is, the success rate is related to the number of embryos transferred, the causes of infertility and the age of the woman. No pregnancy can be guaranteed with ICSI.

Please contact us if you require more information to help you understand this process.