ICSI, Intracytoplasmic Sperm Injection

Male infertility is very common, being a factor in up to half of infertile couples. IUI has been used for decades for the treatment of mild male infertility. Years ago, the only option for couples with moderate to severe male factor was to use donor sperm.

The development of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) makes it possible for most men, even those with severe male factor infertility, to now father genetically related children. The IVF procedure involves collecting eggs and exposing them to sperm in the laboratory. When inadequate quality sperm are available, the ICSI procedure is employed.

ICSI involves injecting a single sperm directly into the egg. This means that an ejaculate with very few quality sperm can still create a pregnancy. ICSI requires micromanipulation equipment that can secure the egg allowing the embryologist to insert the sperm using microscopically guided tools.

Our embryologist, Shari Olsen, Ph.D., has extensive experience conducting this delicate procedure and is highly proficient. The fertilization rate using ICSI is high, typically exceeding 60%.

Using ICSI, it is also possible for men with no sperm in their ejaculate to father a pregnancy. The urologist can withdraw sperm directly from the male reproductive tract using testicular sperm aspiration (TESA) or microscopic epididymal sperm aspiration (MESA). TESA involves extracting sperm from the testicles and using MESA the sperm are withdrawn from the epididymis, which is collection of small tubules within the scrotum.

Such circumstances are typically needed when the tubes leading from the testicle are obstructed, such as in cases involving trauma or a vasectomy, which cannot be reversed.