Weighing ICSI Risks and Benefits
If you are considering intracytoplasmic sperm injection (ICSI) with in vitro fertilization (IVF), it is important to think about the different risks and benefits associated with the procedure.
Intracytoplasmic sperm injection offers you and your partner a chance to have a baby, even with severe male infertility issues. ICSI benefits include helping you get pregnant even if you are dealing with one or more of the following conditions:
- Low sperm count
- Physical blockage
- Poor sperm motility (movement) or morphology (shape)
- Having tried IVF without success
- Desire for pregnancy post-vasectomy
ICSI can increase IVF success rates but the procedure is not perfect. Here are some more common risks associated with ICSI.
Damage to embryos. Fertilization rates with ICSI range from 50 to 80 percent. However, not all fertilized eggs develop into healthy embryos. Unfortunately, some eggs and embryos do become damaged during the ICSI process.
Becoming pregnant with multiples. Since ICSI takes place as part of the IVF process, there is an increased chance of becoming pregnant with multiples for couples that try ICSI. Couples that use ICSI with IVF have about a 30 to 35 percent chance for twins and a 5 to 10 percent chance for having triplets or more.
Carrying multiples increases your chances of developing the following complications during pregnancy and childbirth:
- Gestational diabetes
- High blood pressure
- Low amniotic fluid levels
- Bed rest
- Cesarean section or premature labor
When pregnant with multiples your babies are also at greater risk for complications, such as being born premature with low birth weight, or having difficulty breathing on their own due to immature lungs. They are also more susceptible to infections.
Birth defects. Studies show that ICSI and IVF lead to a similar percentage of birth defects as babies conceived naturally. However, the ICSI risk of having a baby with abnormalities is very minimal (less than 1 percent).
One theory is that ICSI doesn’t allow for a “weeding out” process that might occur with natural conception, and less healthy sperm are allowed to break through the egg barrier. Some speculate that, with ICSI, lower quality sperm are able to fertilize eggs. This may lead to a higher risk of abnormalities.
Some specific risks for birth defects with ICSI include:
- Sex chromosome abnormalities
- Hypospadias (a birth defect in boys where the urethra opening is underneath the penis rather than on the tip)
- Angelman syndrome and Beckwith-Wiedemann syndrome
Ask your doctor about ICSI risks and benefits
It is important for you and your partner to discuss the ICSI risks and benefits with your physician. Your doctor can provide information that’s specific to your personal fertility history.
Getting a better understanding of ICSI risks and how they may impact you and your family can help you make an informed decision on whether or not to pursue this fertility treatment.Sources
- Centers for Disease Control and Prevention: Assisted Reproductive Technology (ART) Report: National Summary.
- American Society of Reproductive Medicine: Patient Fact Sheet: Intracytoplasmic Sperm Injection (ICSI)
- American Pregnancy Association: Intracytoplasmic Sperm Injection (ICSI)
- IntegraMed: ICSI (Intracytoplasmic Sperm Injection) fertility treatment.
- UrologyHealth.org: Management of Male Infertility.