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Intracytoplasmic Sperm Injection (ICSI)

ICSI is a procedure in which a single sperm is inserted directly into the egg, instead of fertilizing the egg the normal way. If it fertilizes, this embryo is then transferred into the uterus with the intention of the woman becoming pregnant.

The ICSI procedure has been developed over the last few years. Fertilization rates of about 70% and pregnancy rates similar to normal IVF pregnancy rates are achieved.

Men whose sperm are unable to achieve adequate fertilization rates in IVF now have the opportunity to father their own children with the use of ICSI, which would not have been possible any other way.

Is ICSI for you?
We do not wish for couples to attempt ICSI unless it is absolutely necessary. We tend not the recommend it unless the sperm parameters are so poor as to indicate that fertilization of the egg in IVF is either very poor or not likely to take place.

This is our general criteria for assessing the quality of sperm:
1. Number
2. Movement
3. Normality

About 40% of males show sub-optimal semen analysis. Only if the number of or movement of sperm is very poor is ICSI considered. In other cases, IVF or IUI may be recommended.

What is ICSI’s success rate?
IVF and ICSI have a success rate of around 35-40%. New techniques are allowing us to constantly improve these odds. For example, the day 5 blastocyst transfer.

The benefits of ICSI
ICSI has been shown to achieve fertilization rates of about 70% (Normal sperm will fertilize about 70% of mature eggs in normal IVF). ICSI has resulted in pregnancy rates that are better than IVF, producing about 35-40% pregnancy rates. These rates are affected by:
1. The age of the woman
2. Her infertility status and cause
3. Quality of embryos transferred

How is ICSI done?
The woman is treated as with all IVF treatments.
The man is required to provide a semen sample on the morning of the egg collection. The sperm are then washed and prepared in a way that allows the sperm head to be able to break down to release its chromosomes once injected into the egg(s).

The egg is examined to ensure it is mature and a single sperm is drawn up into a very small glass injection pipette. This is then injected into the egg and the sperm is released.

The eggs are placed in a culture and examined the following day to see whether they have fertilized normally.

Is ICSI allowed in the context of religion?
ICSI is allowed, provided the treatment respects the confines of marriage. It is religiously and legally allowed all over the Islamic world, with different fatwas from trusted institutions reinforcing that the egg and sperm have to be from the husband and wife. No sperm or egg donation is allowed.