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Intracyoplasmic Sperm Injection
The term “Intracytoplasmic sperm injection (ICSI)” refers to the injection of the sperms directly in to an egg to increase the IVF pregnancy success rates in male related infertility. It is the type of artificial reproduction technology (ART) followed in cases of affected male sperms either in quality or in quantity.
Indications
- Severe oligospermia where the sperm count is less than or equal to 5 million sperm/mL.
- In cases of asthenospermia or teratospermia where the sperms are very weak to swim and reach the egg by itself.
- Presence of sperm antibodies, where the sperm dies due to the antibodies.
- Obstruction of efferent duct system in males.
- Congenital absence of vas deferens bilaterally.
- In cases of unexplained infertility.
Sperm Collection
The ICSI treatment assisted reproductive technology procedure requires the sperm through the normal ejaculation procedure after 2 days of sex abstinence or it can also be retrieved through the other minor techniques like TESE (Testicular sperm extraction) or by MESA (Microsurgical epididymal sperm aspiration). Both washed and unwashed sperms can be used for the process.
Procedure
ICSI procedure is performed under the high quality inverted operating microscope. This is done after the transvaginal oocyte retrieval procedure to extract one or more oocytes from the women. One single spermatozoan or even a spermatid is injected directly into the cytoplasm of an oocyte by micropuncture of zona pellucida. The oocyte is stabilized at 6 o’clock or 12 o’clock position and entered at 3 o’clock position. The correct positions ensure that there is no disturbance caused within the egg during the pipette procedure. The injecting pipette pierces the zona and oolemma and the sperm is directly injected into the ooplasm.
Complications
Although ICSI being most helpful method, some studies have shown that test tube babies born with ART techniques have some complications or health problems due to the acquired infections during the procedures. Such complications or birth defects are septal defects, anorectal atresia, esophageal atresia and cleft palate.
The cost of ICSI treatment in India though are affordable and economic when compared to other western countries but are charged on the basis of each sittings. But this technique is considered to be very effective in achieving the high pregnancy rates in case of male infertility causes when compared to other ART techniques including IVF and subzonal insemination.