Mother and Baby

ICSI: The Fertility Treatment For When He’s Got The Problem

Section: Fertility

If you have decided to opt for fertility treatment, then chances are you have been trying to have a baby for a long time. The different treatments on offer can be confusing. Especially when it’s intracytoplasmic sperm injection (ICSI).

What is ICSI? 

For many couples with infertility problems in vitro fertilisation is a good option. ‘At this point we have the option of just mixing the eggs and sperm together or injecting sperm directly into the egg,’ says Dr Yakoub Khalaf, a consultant in reproductive medicine at Guy’s Hospital in London. ICSI is the second of these choices.

When ICSI is the best option

This procedure is commonly used when men are infertile because they have a low sperm count or sperm that don’t swim well. It can also be an option if a man can’t ejaculate sperm, for example, he may have a blockage or a medical condition preventing him from getting an erection. It can also be used if previous attempts at IVF have failed.

How does it work?

Much of the procedure is just like that for IVF, where the woman is given drugs to stimulate her ovaries and produce eggs. These are then collected using a fine hollow needle directed by ultrasound. In the laboratory, individual sperm are taken from the man’s sample, which he can provide or can be extracted under local anaesthetic, and injected into individual eggs.

Between two and five days later any resulting embryos can be transferred back into the woman’s uterus through her cervix. For women under 40, doctors will transfer one or two eggs. For older women, doctors can transfer a maximum of three embryos.

How long does it take?

One cycle of ICSI takes around four to six weeks. You will need to spend time at the clinic first for egg and sperm collection and then to transfer embryos back in.

About two weeks after this you should be able to take a pregnancy test to see if any of the embryos have taken.

How successful is it?

The chances of having a baby using ICSI are similar to those for IVF, so it’ll be successful for a third of women under the age of 35, but as women get older the success rate falls.

Around one in five women aged 38-39 will give birth after this technique, dropping to 13% in those aged 40-42 and 1.9% over the age of 45.

Are there any risks?

Risks include miscarriage, a reaction to the drugs that are used to stimulate egg production and multiple births from two or three transferred embryos. Because doctors have only been using this technique for around 20 years, there is still a lot we don’t know about the long-term effects for the child. And there is the possibility that boys conceived may inherit their father’s fertility problems.


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