For a long time, most fertility treatments revolved around female-factor infertility. In cases where difficulty conceiving was the result of male-factor infertility, options were limited. These days, advances in fertility medicine have widened our horizons to address many different causes of infertility in both partners. Intracystoplasmic sperm injection (ICSI) was developed to pick the best sperm to place in to egg and to address common issues with sperm, such as low sperm count, poor mobility and other problems. ICSI was first used successfully in the early 1990s, and since then it has helped thousands of patients achieve their dream of becoming parents.

What is ICSI IVF?

Intracystoplasmic sperm injection is a sophisticated Assisted Reproductive Technology (ART) that is used in conjunction with In Vitro Fertilization (IVF) to treat sperm-related infertility problems. It is a highly targeted approach that can be successful where other methods have failed. During ICSI, an embryologist injects an egg with a single sperm to achieve fertilization.

ICSI happens within the IVF process. The female partner will go through an IVF cycle of ovary stimulation, taking carefully timed fertility medications to produce and mature a number of eggs. Then the sperm is collected from the male partner. If possible, he can produce a sample. In other cases where there is an absence of sperm due to blockage or other physiological issues, the doctor can extract sperm under a local anesthetic. There are three different ways that the sperm may be extracted:

  • From the epididymis: a small tube behind the testis. This procedure is called microsurgical epididymal sperm aspiration or MESA.

  • From the testicle: this procedure is known as testicular sperm aspiration or TESA.

  • Testicular tissue biopsy: the doctor may use a needle to perform the biopsy or make a small incision, referred to as a surgical biopsy. In all cases this is a very minor procedure.

Depending on the diagnosis, the sperm sample may be treated to ensure that the most active and healthy sperm are selected for ICSI.