After months of trying to conceive, a diagnosis of infertility can be stressful for men and women who are hoping to have children. Thankfully, many treatments and procedures are available that can help infertile couples get pregnant. Intracytoplasmic sperm injection (ICSI) is a procedure that can help some infertile couples conceive.
Procedure
Intracytoplasmic sperm injection is an optional procedure that can be done during in vitro fertilization (IVF). The normal process of in vitro fertilization includes several steps. First, the eggs are surgically retrieved from a female's ovaries. Then the eggs are mixed with numerous sperm and observed for fertilization and healthy growth. The last step of IVF is the implantation of the fertilized egg into the woman's uterus. For couples that use ICSI, a specialized procedure takes place during fertilization where one single sperm is directly deposited into an egg using a very small needle.
Retrieval of Sperm
Some men produce enough healthy, mobile sperm in their ejaculate to be used for ICSI. Others, who produce no sperm or a very low sperm count, may need to have their sperm surgically extracted for ICSI. In fact, ICSI is one of few fertility treatments that can help men have children when they do not produce any sperm in their ejaculate. Men that have had a vasectomy can benefit from ICSI, as sperm can be surgically extracted from the testes or epididymides for the procedure.
Overall Success Rates
The rate of fertilization of ICSI is quite high. The American Society of Reproductive Medicine reports that ICSI can result in a fertilization rate of 50 to 80 percent. However, an egg can be fertilized yet not result in a pregnancy. Birth rates of ICSI are comparable to birth rates in standard IVF. As of 2007, IVF success rates resulting in live births ranged from 12 percent for women over 40 to 30 percent for women under 35. Younger women are more likely to get pregnant with ICSI and IVF. As with most fertility procedures, the chance of conceiving decreases with age.
Success Rates with Surgically Retrieved Sperm
When sperm are surgically retrieved for use in ICSI, 45 to 75 percent of sperm injections will result in a fertilized egg. About 26 to 57 percent of couples using ICSI with surgically retrieved sperm will achieve pregnancy, and 18 to 54 percent of couples will give birth to a baby. The American Urological Association estimates that most couples will get pregnant with surgically retrieved sperm about 30 to 40 percent of the time. Approximately 25 to 30 percent of these couples will give birth to babies.
Male Infertility
Intracytoplasmic sperm injection can help men increase their fertility, even if they have a low sperm count or poor sperm mobility. Only one sperm is required for ICSI, making this procedure a great option for men with low sperm counts. For men who have had a vasectomy, ICSI with surgical sperm extraction offers an option of having children again, without a vasectomy reversal. An informed discussion with your reproductive specialist can help you make the decision that will work best for you and your family.
References
- American Pregnancy Association: Intracytoplasmic Sperm Injection: ICSI
- Resolve: Micromanipulation Techniques
- American Urological Association, Inc.: Report on Management of Obstructive Azoospermia
- American Society of Reproductive Medicine: Intracytoplasmic Sperm Injection
- Centers for Disease Control: Assisted Reproductive Technology (ART) Report: National Summary
