Intracytoplasmic sperm injection may be the best way to get pregnant if you’re dealing with male factor infertility. Here’s everything you need to know about this fertility procedure, and how it can help you on your journey to parenthood.
Infertility can affect anyone. In fact, people with sperm are just as likely to experience fertility issues as people with eggs.
Luckily, fertility treatments can help with all different types of problems. In cases of male factor infertility , ICSI may be the key to pregnancy for you and your partner.
In this guide to ICSI, we’ll break down what ICSI is, how it works, who should consider this fertility treatment, how effective it is, and how much ICSI costs.
What is ICSI? Intracytoplasmic sperm injection, or ICSI, is a form of assisted reproductive technology (ART). This fertility treatment method is a more specialized and targeted type of IVF. Like conventional IVF, the procedure takes place in a lab.
With ICSI , a single sperm is injected directly into the inside of an egg, aka the cytoplasm—hence the name, intracytoplasmic sperm injection! Then, the resulting embryo is transferred to the uterus.
About half of couples faced with infertility have sperm-related issues, like low sperm count, or sperm that has a hard time swimming or breaking through the egg’s protective barrier. Since ICSI enables sperm to directly penetrate an egg, the procedure offers the possibility of getting a viable embryo despite sperm-related issues.
In other words, ICSI is a key fertility treatment for people dealing with male factor infertility.
Some people may elect to do ICSI (or combine it with conventional IVF), even if they don’t have any particular medical need for the procedure. But experts like the American Society for Reproductive Medicine (ASRM) don’t recommend using ICSI across the board—we’ll get into who should consider ICSI below.
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How does ICSI work? ICSI is a multi-step process, like many ART procedures.
Here are the steps you can expect during your ICSI treatment process:
Producing and collecting the eggs Collecting and preparing the sperm Fertilization with ICSI Embryo transfer Producing and collecting the eggs Like many fertility treatments, the ICSI process generally starts with ovarian stimulation .
Ovarian stimulation is intended to help you produce as many eggs as possible, in order to increase your chances of successful fertilization and a successful pregnancy. To do that, you take ovulation-boosting medication that triggers egg production. Then your doctor extracts the mature eggs from the ovaries in preparation for fertilization.
Collecting and preparing the sperm Sperm is typically collected through ejaculation, generally at your fertility clinic.
If your situation calls for different methods, your doctor might recommend procedures like electroejaculation (EEJ) or surgical sperm extraction. Both these methods are safe, and are commonly used when conditions like spinal cord injuries or nerve problems make unassisted ejaculation impossible.
Then, the sperm is carefully prepared and analyzed (methods vary depending on your fertility needs). Only the best and most viable sperm are selected for the next step.
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Fertilization with ICSI Once the sperm and the eggs are ready, it’s time to fertilize each egg individually using the ICSI procedure. This step is done by doctors in the fertility clinic, so you’re not directly involved.
During the ICSI procedure, special tools are used to:
Hold the egg in place Immobilize and pick up a single sperm (a spermatozoon) Insert the sperm through the outside of the egg Inject the sperm directly into the inside of the egg After the sperm is injected, each fertilized egg is monitored in the lab over the course of 1 to 5 days . During this time, your doctor checks for signs of successful fertilization and development. The goal is to get a viable embryo.
In order to increase your chances of getting a viable embryo, your doctor fertilizes multiple eggs. But remember: one egg, one sperm—meaning each egg only comes into contact with a single sperm (that’s part of what makes ICSI different from conventional IVF).
Embryo transfer Once your doctor determines that a viable embryo is ready, it’s time for the final step: the embryo transfer.
During the embryo transfer, the embryo is inserted into the uterus. Now, the hope is that the embryo will implant in the uterine lining and you’ll become pregnant!
For those interested in fertility preservation , you can also elect to freeze the embryo at this stage instead of doing an immediate transfer.
Is ICSI right for me? If you and your partner are dealing with male factor infertility, ICSI may be the best fertility treatment for your needs—and the best way to get pregnant.
ICSI could be right for you if you’re facing fertility issues like:
Low sperm count : ICSI only needs small quantities of sperm, whereas other ART procedures (including conventional IVF and IUI) need lots of sperm.Sperm motility issues : If sperm doesn’t move in the way it should, you may need ICSI to get the sperm to the egg.Sperm morphology issues : Abnormally shaped sperm may not be able to penetrate an egg without extra help from a targeted procedure like ICSI.Ejaculation issues : ICSI offers another way to fertilize an egg when medical factors, like blockages in the reproductive tract, make ejaculation impossible.ICSI may also be a helpful fertility treatment option if:
You’ve had a vasectomy reversed You’ve undergone multiple conventional IVF cycles and haven’t gotten pregnant You’re using frozen eggs You’re using frozen sperm Some people also decide to do ICSI alongside conventional IVF, as a fertilization backup plan. However, if you don’t have male factor infertility issues and you aren’t using frozen eggs or sperm, current research indicates that ICSI isn’t more effective than conventional IVF. Experts recommend doing ICSI only when there’s a specific medical need for it. In other cases, conventional IVF is often sufficient.
How successful is ICSI? Successful pregnancies with ICSI are thought to occur about 30% to 41% of the time. (For comparison, that’s about the same as IVF.) This rate can vary depending on factors like age and fertility diagnosis.
For male factor infertility, ICSI is more effective than conventional IVF, meaning the chances of having a baby in this scenario are higher with ICSI.
How much does ICSI cost?
ICSI is typically charged as an added fee in an IVF cycle. At baseline, an IVF cycle may cost over $12,000 . Some data indicates that ICSI can cost around an extra $1,500 per IVF cycle in the United States, but fees may vary depending on the fertility clinic.
What is ICSI? The bottom line ICSI is a safe and effective ART procedure that involves injecting a single sperm directly into a single egg, then transferring the resulting embryo to the uterus.
This fertility treatment is likely the most effective way to get pregnant when facing male factor infertility. So if you’re dealing with sperm-related issues and other male factor infertility problems, ICSI may be the key to having a baby.
Your fertility care team will help you figure out if ICSI is right for you, so you can choose your treatment path and move forward on your journey to parenthood.
