icsi

Intracytoplasmic sperm injection (ICSI) can be used as part of an in vitro fertilisation (IVF) treatment to help you and your spouse to conceive a child.ICSI is the most successful form of treatment for men who are infertile and is used in nearly half of all IVF treatments.ICSI only requires one sperm, which is injected directly into the egg. The fertilised egg (embryo) is then transferred to your uterus (womb)

ICSI is likely to be recommended if your spouse has: A very low or zero sperm count.A high percentage of abnormally shaped sperm. This can result in poor motility, which means the sperm can't swim well.Sperm that can't be ejaculated but can be collected from the testicles or from the duct where sperm is stored (epididymis). This may be needed if your spouse has had an irreversible vasectomy or injury

Your spouse may produce a sperm sample himself by ejaculating into a cup on the same day as your eggs are collected. If there is no sperm in his semen, doctors can extract sperm from him under local anaesthetic. Your doctor will use a fine needle to take the sperm from your spouse's: epididymis, in a procedure known as percutaneous epididymal sperm aspiration (PESA), or testicle, in a procedure known as testicular sperm aspiraction (TESA)

TESA is sometimes carried out before the treatment cycle begins, and under local anaesthetic. The retrieved sperm are frozen. Any discomfort felt by your spousepartner should be mild and can be treated with painkillers

The procedure then follows the same steps as in IVF. The doctor transplants one or two embryos into your uterus and through your cervix using a thin catheter.

The success rates for ICSI are higher than if you use conventional IVF methods. A lot depends on your particular fertility problem and your age. The younger you are, the healthier your eggs usually are, and the higher your chances of success. The percentage of cycles using ICSI which result in a live birth are: 35 per cent if you are under 35; 29 per cent if you are between 35 and 37; 21 per cent if you are between 38 and 39; 14 per cent if you are aged between 40 and 42; six per cent if you are between 43 and 44; five per cent if you are over 44

ICSI may give you and your spouse a chance of conceiving your genetic child when other options are closed to you.If your spouse is too anxious to ejaculate on the day of egg collection for standard IVF, sperm can instead be extracted for ICSI.ICSI can also be used to help couples with unexplained infertility, though experts haven't found that ICSI makes pregnancy any more likely than standard IVF.

ICSI is a more expensive procedure than IVF. ICSI has been in use for a shorter time than IVF. So experts are still learning about its possible effects. The same risks associated with standard IVF procedure, such as multiple births and ectopic pregnancy, apply to ICSI. You may have a higher risk of congenital conditions such as cerebral palsy in your baby. The risk rises from three per cent for naturally conceived children to about six per cent after IVF or ICSI. One large study found a higher rate of abnormalities in ICSI babies when compared with IVF babies. But this risk is still low.