Reproductive Assistance - Intracytoplasmic Sperm Injection

What Is It?

Intracytoplasmic sperm injection (or insertion or microinjection), also known as ICSI, is an innovative procedure used to literally inject the male gamete (sperm) into the female gamete (egg) in an effort to achieve conception.

ICSI is truly one of the marvels of assisted reproductive technology. Rather than simply placing the two sex cells in a petri dish filled with medium to encourage fertilization, ICSI more closely assures the process by doing some of the sperm's work for it. Specifically, by using this micromanipulation technique, doctors are able to bypass problems that the sperm may have with penetration of the zona pellucida, the egg's outer shell.

Accordingly, one must be undergoing in-vitro fertilization (IVF) in order to make use of the ICSI technique, and you'll often see it referred to as IVF/ICSI.

In brief, the procedure involves the following steps:

  • The woman uses fertility medication to "superovulation".
  • Sperm sample is obtained, either through masturbation, via an extraction technique, or a donor, and appropriately "washed".
  • Oocytes (eggs) are harvested, processed, and observed for maturity and potential.
  • Sperm solution is placed in a petri dish.
  • Prepared oocytes are then placed in the same dish.
  • Using two pipettes, one to hold the egg and one to inject the sperm, a single chosen sperm is aspirated into the pipette tail first and swiftly injected into the cytoplasm of the egg.
  • The eggs are then evaluated for fertilization at 12 hours post-injection, and at 24 hours for cleavage (assisted hatching may be necessary).
  • Approximately 72 hours post-injection, resulting good quality embryos are ready for transfer to the woman's uterus or cryopreservation.

Advanced Fertility Center of Chicago and the Assisted Conception Unit of University College Hospital in London use photographic images to describe the ICSI process. Oxford University's Nuffield Department of Obstetrics and Gynaecology offers video clips of ICSI procedures.