When is ICSI preferred over conventional IVF?

ICSI can provide a solution when the sperm is unable to fertilize the egg by itself (as happens in conventional IVF)

Such cases are the following:

• Weak sperm
• Large number of anti-sperm antibodies in the sperm
• History of poor fertilization after conventional IVF
• Sperm acquisition after testicular or epididymal biopsy

How is ICSI actually done?

ICSI takes place on the same day as the egg collection.

The embryologist uses specialized equipment and a powerful microscope to grasp a sperm and inject it directly into the egg.

Unlike conventional IVF, where nature chooses the best sperm to fertilize the egg, in ICSI it is the embryologist who selects what appears to be the best sperm amongst dozens of others.

As a result, nowadays almost every man can father his own child, even if his sperm is very weak.

What else do I need to know about ICSI?

• ICSI helps a lot, but it cannot solve all male fertility problems.

ICSI does inject a sperm inside the egg, but it cannot guarantee that the egg will get fertilized. The average fertility rate after ICSI is 70-80%.

On top of that, in a very small percentage (2-3%) of cases, the egg may be irreparably damaged during the manipulations required for ICSI.

• Children conceived through ICSI are almost as healthy as children conceived through conventional IVF or natural conception.

Studies suggest that there MAY be a reduction in the reproductive potential of the boys born through ICSI. This is linked to the possibility that male infertility may be – to some degree – hereditary. Therefore, it is possible that men may transfer their infertility to their sons, who may in turn need help to have a child.

In other words, ICSI may help men who would ‘normally’ never father children to have a child who could have fertility problems himself.

There is still ongoing research in this area.