Intracytoplasmic Sperm Injection (ICSI) - treatment

The Private Healthcare UK guide to infertility treatment contains articles on infertility and IVF treatment which are aimed at improving your knowledge of treatments for infertility, their benefits and potential risks.

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The female partner undergoes the same drug regime and egg collection procedure as in standard IVF treatment.  The male partner produces sperm, either in the normal way or through surgical retrieval.

ICSI uses sperm that would otherwise not be able to fertilise an egg, so the main difference between ICSI and IVF is what happens in the laboratory.  In standard IVF treatment, many thousands of sperm are mixed with each egg and it is hoped that one of the sperm will penetrate the zona pellucida (outer shell of the egg) to begin the fertilisation process.  When ICSI is used, a single sperm is injected directly into the cytoplasm of a mature egg.  ICSI circumvents several steps in the natural fertilisation process, such as sperm-zona binding, zona penetration and fusion of the gametic cell membranes.

Any damage to the eggs is observed at the time of the injection procedure and the damaged eggs are not used.  An average of 10% of the eggs are generally discarded.  The eggs that fertilise are then allowed to develop over the next few days.  Embryo transfer is carried out as in a standard IVF treatment cycle.

According to HFEA regulations, eggs that have failed to fertilise after 24 hours during a standard IVF procedure are not to be used in ICSI treatment.  Only in exceptional circumstances is it allowed to transfer ‘mixed embryos’, resulting from ICSI as well as from IVF in the same treatment cycle.

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