Should I use ICSI?

The general idea behind In Vitro Fertilization (IVF) is that an egg is removed from a woman’s body and fertilized in the lab. Traditionally, sperm are placed in a lab dish next to an egg and left to fertilize the egg on their own. But this conventional method doesn’t always work. 

We know that of the people experiencing infertility, about 30% of the time the cause is male-related. The sperm might not be of good quality or not quite strong enough to fertilize the egg by itself. A solution to overcome male infertility has been the use of intracytoplasmic sperm injection (ICSI). 

How Does ICSI Work? 

ICSI is done in conjunction with IVF. Fertility medication is used to increase egg production in a woman and the eggs are retrieved from the ovaries to be fertilized in the lab. In the natural process of fertilization, a sperm must attach to the outside of an egg, break through the outer wall and reach the cytoplasm for fertilization to take place. 

When we use ICSI, we assist this process by injecting a single sperm directly into a mature egg using a tiny needle, called a micropipette. This maximizes the chances of the sperm reaching the cytoplasm and successfully fertilizing the egg. 

When Would We Use ICSI? 

Embryologist performing icsi in the lab during IVF

ICSI was first used when severe male infertility prevented fertilization through traditional methods. This process can help overcome barriers that the sperm might encounter as a result of male infertility. 

Some common causes of male infertility can be: 

  • Sperm Volume 
  • Low Sperm Count 
  • Sperm motility (the sperm’s ability to move independently)
  • Sperm morphology (the size and shape of the sperm) 

Learn more about the signs and causes of infertility in men.

When dealing with the causes listed above, a sperm sample is collected and analyzed by the embryologist to identify the strongest, healthiest sperm. The top candidates from the sample are then used in the ICSI process. By overcoming the sperm’s limitations, we can increase the number of embryos available and have an even better chance of creating a successful pregnancy.

ICSI has been successful in helping intended parents struggling with male infertility realize their dream of growing their family. But it’s not limited to these patients, it is also widely replacing traditional methods for fertilization across the board for other reasons.

Can ICSI Be Helpful Even When Male Infertility Isn’t an Issue? 

ICSI was initially used to help overcome obstacles of male infertility but sometimes insemination can fail even when the sperm looks normal. There may be issues with the binding ability of the egg and sperm or other circumstances preventing fertilization. 

ICSI can also be used when someone decides to have their embryos undergo Preimplantation Genetic Testing (PGT). PGT is a genetic analysis of embryos that checks for any chromosomal abnormalities and can screen for specific genetic diseases. By using ICSI, we reduce the risk of contaminating the cells taken from embryos for testing and increase our chances of receiving accurate PGT results. 

What are the risks of using ICSI? 

As with any medical procedure, there are some risks involved. While traditional insemination can run the risk of failed fertilization, ICSI also carries a small risk to damage the egg. ICSI can be an invasive procedure and there are unknown variables that can affect the health of the egg. It’s important to talk to your doctor about the risks and benefits of using ICSI in your fertility treatment. 

Is ICSI Right for Me? 

Generally, if we are using healthy sperm, the success rates of fertilization using conventional methods should be about the same as ICSI. Unfortunately, there can be hidden issues with the egg and sperm fusion and it’s nearly impossible to tell if a single sperm is able to fertilize an egg until they meet. 

You might consider ICSI if you are facing male-factor infertility, interested in preimplantation genetic testing, or a variety of other reasons. Talk to your fertility specialist about why ICSI might be the right option for you as you grow your family.  


Want to learn more about ICSI and IVF at ORM Fertility? Contact our team to schedule an appointment with one of our fertility specialists to learn if ICSI can help you realize your dream of growing your family. 

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