|
|
In general, ICSI is a treatment for male-factor infertility. This procedure mechanically ups the fertilization odds so that only one "good" sperm is needed to fertilize each oocyte that is harvested. More specifically, some of the male situations that ICSI can treat are:
In addition, the following conditions may be remedied by the use of ICSI:
Each clinic uses its own criteria for indicating which patients are good candidates for ICSI. For more details on types of sperm problems for which ICSI may be used, see Fertilitext's ICSI page.
First applied to human gametes in 1988, the first pregnancies resulting from ICSI were reported in 1992. It has become the treatment of choice for individuals with male-factor infertility. In general, success depends on the following variables:
Along with the risks of IVF, individuals using ICSI incur additional risks specific to the micromanipulation of gametes.
According to the American Society for Reproductive Medicine's fact sheet, one can expect fertilization rates of 50 percent and cleavage rates of 80 percent; however, "only 15 to 20 percent of egg retrievals produce a baby", and factors like poor egg quality or maternal age may result in lower percentages. The same fact sheet states that the risk of birth defects for babies born as a result of ICSI and in the general population is similar.
The impact of ICSI's use on resulting progeny is debated. Concern has been expressed regarding this ability to bypass the potential "natural order" of male fertility, with fears that resulting children may have higher than average rates of congenital abnormalities. Studies have been conducted (link access requires free registration) to address these concerns, with varying results. All agree that more time is needed to fully assess the long-term impact, and many would encourage individuals using ICSI to engage in genetic counseling, preimplantation diagnosis, and prenatal diagnosis throughout the process.
© Tracy Morris
