Intra-Cytoplasmic Sperm Injection (ICSI) is
a modification of the in vitro fertilisation (“Test-tube
baby”) technique where the egg is fertilised outside
the body by injecting the sperm directly into it. The embryo(s)
are then introduced back into the woman’s uterus in
the same way as for IVF.
ICSI is typically suitable for several groups
of patients, such as:
- Men with abnormal semen parameters.
- Couples with previous poor fertilisation using IVF.
The woman is given fertility drugs to stimulate
her ovaries and the development of several mature follicles.
Each of these follicles may contain an egg. The recruitment
and development of the follicles is regularly monitored by
ultrasound scans and blood tests. This is to ensure that the
ovarian stimulation is both safe and effective.
Once suitable mature follicles have been produced
the eggs are collected using an ultrasound-guided needle.
This procedure is performed under sedation/local anaesthetic.
The collected eggs are then placed into culture in the embryology
laboratory.
The male partner then produces a semen sample,
which is then prepared in the laboratory. The aim of the preparation
process is to obtain motile, normal looking sperm to be injected
into the mature eggs. The Embryologist, using microscope-guided
micromanipulators, injects the sperm into suitable eggs.
.
Next morning the eggs are inspected for signs of fertilisation.
Those eggs that have normal fertilisation are cultured in
the laboratory for another 24 – 48 hours. The development
of the embryos is monitored and the patients kept advised
of their progress.
Our fertility specialist performs the embryo
transfer procedure. The selected embryos are introduced, through
a fine catheter, into the woman’s uterus. Typically
2-3 embryos are transferred depending on the patient’s
circumstances. The embryo transfer procedure takes no more
than half an hour and few women experience any discomfort.
The spare embryos are then assessed in terms
of their suitability to be cryopreserved for use, by the couple,
in future cycles.