What is an Intracytoplasmic Sperm Injection?

Intracytoplasmic sperm injection is an innovative laboratory technique to accomplish in vitro fertilization. It is preferred over other forms of assisted reproduction therapy when it is known that the male partner has infertility problems. The procedure involves injecting a single sperm cell into a mature egg until fertilization occurs, then transplanting the egg back into the uterus so normal pregnancy can occur. There are slight, unpredictable risks of genetic defects in embryos conceived via intracytoplasmic sperm injection, but newer technologies and techniques continue to minimize the chances of abnormalities.

A couple might consider intracytoplasmic sperm injection after a fertility doctor deems the male partner to have a very low sperm count, weak sperm motility, or generally poor sperm quality. Enough healthy sperm can usually be harvested from ejaculate samples using a microscope and a sophisticated collection tool. If there are no sperm at all in ejaculate samples, a couple can still consider going through with the procedure using a donor. Approximately 10 to 12 mature eggs are harvested from the female's ovaries through an ultrasound-guided procedure.

A laboratory specialist performs intracytoplasmic sperm injection by isolating a single egg in a sterile test tube or pipette and injecting a single sperm into its cytoplasmic center with a needle. The doctor removes the needle, ensures there is no accidental physical damage to the egg, and stores it in a sterile, temperature-controlled holding area. The procedure is usually repeated for every available mature egg to provide the best chances of at least one successful fertilization.

Eggs are checked approximately 24 hours after intracytoplasmic sperm injection to see if fertilization has occurred. The two or three maturest zygotes are selected from the group of fertilized eggs and placed in a catheter device. A specialist can then inject the zygotes into the female patient's uterus. Several weeks of careful monitoring and testing are needed to ensure that normal pregnancy begins.

Some hopeful parents, doctors, and researchers have concerns about the safety of intracytoplasmic sperm injection. The procedure has a high success rate, but it also carries an elevated risk of giving birth to a child with a genetic abnormality. The risk is very small, but it is still significantly higher than would be expected during traditional conception. It is important for a couple to thoroughly discuss the risks and benefits of intracytoplasmic sperm injection with several experts, including genetic counselors and obstetricians, before deciding to go through with the procedure.