If you are considering in vitro fertilization (IVF) and your partner has male factor infertility, the intracytoplasmic sperm injection (ICSI) procedure may be right for you. During the ICSI procedure, only one tiny sperm is needed during IVF to fertilize your egg.
Low sperm count?
There are specific steps during the ICSI procedure, which is performed with IVF:
- Sperm are taken from semen or surgically extracted from your partner’s testes or epididymis
- Your eggs are surgically extracted from your ovaries
- Using a tiny hollow needle, the sperm is carefully injected into the egg
- After injection, the fertilized egg is observed for growth and development
- Once normal growth is observed, the embryo will be implanted
Some fertility clinics use fresh sperm that have just been extracted, while others prefer to do the ICSI procedure with frozen sperm. There appears to be no difference in pregnancy rates between those who use fresh or frozen sperm during the ICSI process
Help for male factor infertility
The ICSI procedure allows you to get pregnant with IVF, even if you and your male partner have experienced the following:
- absence of sperm in the semen, which is sometimes caused by a blockage
- low sperm count
- poor sperm quality and/or abnormal sperm shape and movement
- sperm that can’t penetrate through the outer layer of your egg
- male production of antisperm antibodies
- IVF has already been attempted without success
Perhaps you wonder how doctors can fertilize your egg with just one sperm. The ICSI procedure is done with a technique called micromanipulation.
Micromanipulation uses a special microscope along with very small surgical tools to pick up and handle the sperm, thus helping you get pregnant.
ICSI procedure and post-vasectomy
If your partner has had a vasectomy, the ICSI procedure offers you a chance to get pregnant again. Or if your partner’s vasectomy reversal was unsuccessful, the ICSI process may help you to conceive.
In fact, if you are older than 37 or have female factor infertility, the IVF/ICSI process offers you a better chance of getting pregnant compared to a vasectomy reversal. Some women get pregnant within 1 to 2 months after starting hormonal therapy and undergoing IVF/ICSI.
Couples that get pregnant after a vasectomy reversal usually take about a year to conceive. If your partner does undergo a vasectomy reversal procedure, the surgeon can go ahead and remove sperm during the operation. These sperm will be frozen for later use with IVF/ICSI in case you are unable to conceive naturally after the vasectomy reversal.
How successful is the ICSI procedure?
If your partner has a blockage or low sperm count you have about a 30 percent chance of getting pregnant with each cycle of IVF with ICSI. This success rate is similar to couples that use IVF without ICSI. Of course, this rate of success will be lower for women older than 37.
Unfortunately problems do occur during ICSI procedures. Sometimes the eggs are damaged or the embryo might not grow after the sperm is injected into it.
Concerns about the ICSI process
One concern for some couples is the high cost and invasive techniques required during the ICSI process. If a man does not produce sperm in his semen, his doctor may have to surgically retrieve the sperm, which could lead to side effects.
IVF also carries the risk of getting pregnant with multiple babies, which can increase complications with pregnancy and childbirth. Some reports say that boy babies are born less frequently with the ICSI procedure, when compared to birthrates from natural conception.
Some people speculate that the ICSI process might lead to higher rates of genetic defects compared to other forms of conception. But, the birth defects most commonly associated with ICSI are usually able to be fixed with surgery.
ICSI is a major advance
If your partner has male factor infertility, the ICSI process may help you get pregnant. Make an appointment to talk to your doctor to see if the ICSI procedure is the right option for you.
Sources: American Pregnancy Association “Intracytoplasmic Sperm Injection: ICSI” American Society of Reproductive Medicine “The management of infertility due to obstructive azoospermia” “Vasectomy Reversal” “Intracytoplasmic Sperm Injection (ICSI)” American Urological Association, Inc. “Report on Management of Obstructive Azoospermia” “Getting Help for Obstructive Azoospermia”
