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Intracytoplasmic Sperm Injection, ICSI

Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is used as a part of the treatment called In Vitro Fertilisation (IVF). These procedures are aimed to help infertile couples conceive a child. ICSI is the most successful treatment option for infertile men, used in about half of all IVF procedures.

Intracytoplasmic sperm injection requires testicular sperm extraction and direct injection into the female egg. When the egg has been fertilised the embryo is transferred into the uterus (or womb) of the woman.

In particular, ICSI is useful when the sperm is unable to reach the egg or when it cannot fertilise it once it gets there.

Who Is ICSI Recommended to?

Intracytoplasmic sperm injection does not offer solution for every male fertility problem. Before ICSI the doctor performs blood tests and investigates the causes of infertility, but males should get counselling before and have some tests performed in order to decide the best treatment.

ICSI is recommended when:

  • The man has low sperm count.
  • Sperm is abnormally shaped and cannot swim well.
  • The sperm doesn’t ejaculate but is collected in the testicles or in the epididymis.
  • The man has had an injury or an irreversible vasectomy.
  • Due to spinal cord injuries or diabetes, there are ejaculating or erection problems.

 The ICSI Procedure

As intracytoplasmic sperm injection belongs to the In Vitro Fertilisation treatment, the woman is given fertility drugs to stimulate ovaries. These drugs help her to develop several mature eggs for fertilisation. Once the egg is ready for collection, man and woman undergo separate procedures.

The man produces a sperm sample the same day the female eggs are collected. In cases when no sperm is present in the semen, doctors perform a testicular sperm extraction with local anesthesia.

Doctors may find sperm in:

  • The epididymis – the procedure is called percutaneous epididymal sperm aspiration (PESA)
  • The testicle – the procedure is called testicular sperm aspiration (TESA)

If neither technique succeeds in removing enough sperm, the doctor may take a biopsy of the testicular tissue, during a microscopic or micro-TESE procedure.

Then the woman receives local anesthesia and the doctor removes the eggs using a hollow needle (ultrasound is used to locate the eggs). Afterwards, the embryologist isolates an individual sperm and injects it into the individual egg.

Results are apparent two days later, when the egg will transform into little balls of cells.

In Vitro Fertilisation

Intracytoplasmic sperm injection (ICSI) procedure precedes the IVF procedure: the doctor then transplants one or two embryos into the uterus. A thin catheter is used to implant the embryos through the cervix.

For women under 39 years of age, it is recommended to have a Single Embryo Transfer (SET) which increases the chance of having a healthy single baby and improve both the mother and the baby’s health.

For women older than 40, two embryos are recommended for transfer. After two weeks, pregnancy tests must be done.

Intracytoplasmic Sperm Injection Cost

In the U.S. Intracytoplasmic sperm injection cost can go up to $15,000 for one cycle of ICSI. The average cost is around $1,500 which is added to the cost of IVF treatment.

Intracytoplasmic sperm injection cost is to be paid up front, now that insurance policies in the U.S. do not cover the treatment.