ICSI is a procedure whereby a single sperm is artificially inserted directly into the egg of a woman instead of penetrating the egg in the normal way. If it fertilizes, this embryo is then replaced into the uterus of the woman as is done in the regular in vitro procedure.

WHY SHOULD I CONSIDER ICSI?

Approximately one man in 25 has sperm qualities that make it impossible for him to father children normally.

About 13% of these men have untreatable sterility; many have no sperm at all. Some do produce sperm which are either not motile (do not swim) or do not have the normal shape and structures which are required for penetration of eggs. These men, plus a further 10% (approximately) who have either very low sperm counts, very low percentage of motile sperm, a very large percentage of abnormally shaped sperm, or a mixture of these problems, have sperm that do not adequately fertilize eggs in normal IVF. These men are the most likely to benefit from ICSI.

Those couples who have tried IVF and no fertilization (or only occasional fertilization) was achieved, and where the cause of the reduced fertilization rates is attributed solely to the poor fertilizing ability of the sperm, are the ones selected for ICSI. Where there are fertilization rates less than 40% ICSI is the treatment of choice.

WHAT ARE THE BENEFITS OF ICSI?

ICSI is only suitable for attempting fertilization when the sperm are unable to penetrate the egg during routine IVF procedures. ICSI has been shown to achieve fertilization rates of about 70%. ("Normal" sperm will fertilize about 70% of mature eggs in normal IVF). ICSI has resulted in pregnancy rates that are similar to IVF success rates. These rates depend to a large extent on:

-- Age of the woman
-- Her infertility status and cause
-- Number of embryos replaced

Men whose sperm are unable to achieve adequate fertilization rates in IVF now have the opportunity to father their own children with the use of ICSI. Evidence shows that the incidence of abnormalities in fetuses and children resulting from ICSI procedures is no greater than in the normal population.