What is ICSI? 5 facts you need to know

13 Feb What is ICSI? 5 facts you need to know

What is ICSI? Most fertility patients know the basics. Fertilisation of an egg cell using ICSI means injecting a sperm cell directly into it. The aim? Better IVF fertilisation rates. But there’s more to ICSI than that. Here are five key things to think about.

1. Donor sperm, anyone? Not anymore.

Since the first ICSI (intracytoplasmic sperm injection) procedure in 1992, the use of donor sperm has dropped dramatically. More than 95% of men can now be birth fathers thanks to ICSI. It’s often overlooked just how much ICSI has helped with male infertility. It was the second IVF revolution.

2. ICSI is cheap to do – so don’t get fleeced.

ICSI only takes a skilled embryologist a few minutes to do. Yet some clinics charge hundreds, even thousands of pounds to carry it out. That’s pretty outrageous in our book. Look for clinics who include ICSI as part of their IVF treatment packages. Many overseas clinics do. Most UK clinics do not.

3. ICSI’s not just for men.

Back in the 90s, medics thought ICSI would only help couples with a male-infertility issue. While it undoubtedly helps isolate the best sperm in a sub-optimal sperm sample, ICSI pregnancy rates are sometimes better than standard IVF fertilisation methods. More stats are needed, but ICSI has developed a lot in 25 years. Micro-manipulation techniques and equipment have improved. More clinics do it and expertise has sharpened. Patients who produce fewer eggs, or who have a history of poor fertilisation, may also need ICSI to ensure fertilisation happens. So male-factor issue or not, it’s worth considering ICSI as part of your IVF cycle.

4. Men: here’s when you need it.

First, have a semen analysis. And have a proper one that looks at the five key parameters: volume, concentration, motility, progressive motility and morphology. It’s amazing how often we see test results that don’t cover all five bases. If sperm concentration is below 15 million/ml, ICSI will help. Same goes for a progressive motility score of less than 32%. And if morphology is less than 4%, ICSI may, arguably, help things along too.

5. Successful ICSI is down to several things, not just one.

IVF cycles using ICSI rely on many factors along the way. This makes quantifying the benefits of ICSI tricky. If the female patient is fertile and the male patient has a sperm issue, the ICSI cycle is more likely to succeed. So that’s more to do with the female prognosis than the male problem. An ICSI cycle is also only as good as the embryologist doing it, the quality of the lab and the skills of the doctor performing the embryo transfer. So ask your clinic about all of these before having it.

So what is ICSI all about? It’s about pinpointing the best sperm, improving fertilisation rates, potentially boosting pregnancy rates and addressing certain egg-related problems. More importantly, ICSI is a technique that’s got better over the years. It has focussed attention of ways to improve sperm selection and thus improve IVF outcomes. So it’s a stepping stone to more live births. Talk to your clinic to see if ICSI is right for you.