When is ICSI treatment necessary?
During the IVF process, we normally use standard insemination — the egg, which sits in a laboratory dish, is exposed to thousands of sperm. The fittest sperm will fertilise the egg and in this sense, the process is ‘natural’.
However, for a sperm to successfully fertilise an egg during IVF, it must penetrate the egg’s outer covering. This process may prove difficult for the sperm for a number of reasons, including:
- Low sperm count
- Poor sperm motility (the ability of the sperm to move)
- Abnormal sperm morphology (shape)
- Frozen sperm is used
- Sperm from a testicular biopsy is used.
A semen analysis, the primary fertility test for males, will be performed as part of our initial fertility assessment to assess these parameters. Our semen analysis facility, based at our Box Hill clinic in Melbourne, meets the World Health Organisation’s 6th edition standards, reflecting the latest recommended criteria for semen testing. We are also one of only a few laboratories in Victoria able to offer DNA fragmentation testing of sperm.
Based on the results of your semen analysis, your fertility specialist will then inform you if ICSI is recommended to help increase the chances of a successful IVF treatment cycle. Additionally, we may recommend ICSI treatment if you have previously undergone one or more cycles of IVF, but these were unsuccessful due to poor fertilisation using the standard approach of natural insemination.
How does ICSI treatment work?
In intracytoplasmic sperm injection, a single sperm is injected directly into the centre of a mature egg. By injecting the sperm into the egg, the sperm no longer has to successfully penetrate the outer covering of the egg, making it easier for fertilisation to occur. However, it still does not guarantee successful fertilisation. This procedure requires expert technique and precision and thus is only performed by suitably experienced embryologists.
The intracytoplasmic sperm injection process
Intracytoplasmic sperm injection is performed as part of the IVF treatment process. Following egg retrieval and sperm collection (via self-collection or testicular biopsy), the sperm are microscopically assessed for motility, size and shape. Based on this assessment, one sperm is selected for intracytoplasmic sperm injection.
The selected sperm is gently injected into the centre of a mature egg (we will assess the egg first to ensure it is mature). If fertilisation is successful, the resultant embryo is then grown and transferred into your uterus (this procedure is referred to as ‘embryo transfer’).
We’re committed to using advanced scientific techniques — that’s why we use egg spindle visualisation.
For ICSI procedures, we use an incredibly powerful microscope that uses polarised light. This leading technology allows us to assess whether an egg is in optimal condition for fertilisation and to identify the best position to inject the sperm into the egg. Additionally, it provides feedback if fertilisation with ICSI treatment is unsuccessful; our scientists can assess whether the egg or the sperm was responsible by assessing a structure called the ‘spindle’. This knowledge assists us in planning our approach to subsequent IVF treatment cycles.
