So many intended parents always ask the question to ICSI or not during their egg donor journey. You ask, “What is ICSI?” ICSI is an acronym for intracytoplasmic sperm injection. In laymen’s term it means to ” inject a single sperm directly into an egg in order to fertilize it.” Where in traditional fertilization many sperm are placed together with an egg in a petri dish in a lab, in hopes that one of the sperm will enter and fertilize the egg. I think that over the course of several years the use of ICSI has increased regardless of a sperm issue or not. According to Dr. Sherbahn of Fertility Center of Chicago he states that, “About 25% of all infertility is caused by a sperm defect and 40-50% of infertility cases have a sperm defect as the main cause, or a contributing cause. In cases like this the use of ICSI increases the chances of someone using their spouse or partners sperm that without ICSI their chances of good fertilization would be much lower or if possible at all.
The way that ICSI is preformed your doctor first retrieves the eggs from the egg donor. The semen sample is prepared by centrifuging, or spinning the sperm cells through a special medium. This separates live sperm from debris and most of the dead sperm.Then an embryologist places the eggs in a special culture in the lab. Using a tiny hollow sharp needle to immobilize and pick up a single sperm with the guidance of a microscope the embryologist will select the best possible single sperm and inject it into the egg. This process is done individually on each egg retrieved.
I think it’s fantastic that ICSI does offer a lot of benefits, but just like anything in the realm of infertility treatments some reproductive embryologist and embryologist feel that ICSI does come with risk. Believe it or not ICSI has not been around that long. One of the first cases of ICSI was report in 1994 which was followed by a live birth in 1995 at UCSF in the San Francisco Bay area. They were the first program in their area to have success with this procedure. Now you ask what are the risk involved? Damage to embryos, becoming pregnant with multiples and some believe birth defects. In all honesty studies show that ICSI and IVF lead to similar percentage of birth defects as babies conceived naturally. The great news from studies say that, “when using ICSI the risk of having a baby with abnormalities is very minimal less then one percent. Remember just because you’ve decided to do ICSI it doesn’t guarantee that all your eggs will fertilize and develop into nice healthy embryos.Yes, unfortunately some eggs and embryos through ICSI do become damaged.
Speaking with your RE would be a good first step in determining if ICSI is needed in your situation or you electively would like to do it. You should always discuss the risks and benefits. Doing ICSI does not increase the overall embryo quality compared to non-ICSI embryos. And there is no difference in pregnancy rates being show between ICSI and non-ICSI embryos. With the average fertilization rate of 8 out of 10 eggs fertilizing normally with the use of ICSI more and more clinics are doing it electively.Return to Blog