Intra-Cytoplasmic Sperm Injection (ICSI)

Intra-cytoplasmic sperm injection, or ICSI, is, basically, in-vitro fertilization carried one step further. Ultimately used for men with extremely low sperm counts or reduced sperm motility, ICSI now offers men with poor semen parameters a chance of achieving a pregnancy.

With conventional IVF, sperm and eggs are placed together in a dish and fertilization must occur naturally i.e. the sperm must have the ability to penetrate the egg under it’s own power. With ICSI, only one sperm is required for each egg, and one sperm is injected into one egg with a fine needle visualized under a high powered microscope.

Indications for ICSI are as follows:

• Men with an extremely low sperm count, low motility, or a high percentage of sperm with abnormal morphology.

• A low fertilization rate (or no fertilization) demonstrated by conventional IVF.

• Poor embryo quality felt to be secondary to a sperm problem with conventional IVF.

• Men requiring testicular aspiration or biopsy to obtain viable sperm.

At the Markham Fertility Centre, we do not believe that ICSI should be performed unless absolutely necessary. Allowing an egg to be fertilized via conventional IVF may produce better quality embryos when compared to an egg that is injected. To create a good quality embryo by ICSI, several factors need to be in place, including good egg quality and an experienced ICSI lab technician.

If a couple has never achieved a pregnancy in the past or there is no history of proven fertilization, we often recommend that a couple proceed to both conventional IVF and ICSI for their 1st IVF attempt. This allows us to give couples more answers and insight into their infertility problem, including determination of egg quality, sperm fertilization capability and subsequent embryo or blastocyst quality.


Factors Affecting Implantation