Intracytoplasmic Sperm Injection (ICSI)

In case of couples with a history of poor or failed fertilization or in cases where the sperm availability is very low ICSI is the preferred method. The procedure involves injecting a single sperm directly into the egg thus aiding in fertilization.

Treatment procedure for ICSI:

During a standard IVF cycle, mature eggs must be retrieved from the female partner prior to performing ICSI. In order to isolate as the maximum number of healthy moving sperm, the semen sample is isolated in the lab. The eggs are allowed to rest for approximately 2-3 hours after extraction. Then the cumulus or the tight outer covering of the eggs are removed to ensure that the eggs are mature enough for an ICSI procedure.

Immature eggs are incubated for another 2-6 hours and then reassessed. They are not injected. On maturity they are injected along with the other mature eggs.

The egg is held in place using a special instrument that is so small that its tip cannot be viewed with naked eyes. A sperm that appears normal is picked with a thinner, sharp, needle-like instrument. This needle is then inserted thorough the outer coating of the egg and into the egg. This requires great precision. Slowly the sperm is injected and the needle withdrawn, leaving the sperm in place.

These eggs that have been injected are incubated overnight and checked the following morning for signs of fertilization. An additional 24 hours are required to determine if the cells have divided and gone to form an embryo. In a typical cycle, not all of the eggs get fertilized neither do all the fertilized eggs form an embryo. Depending on the womans age and medical history we decide on the number of embryos to be transferred to the uterus. Additional healthy embryos may be frozen if required.

The success of the procedure largely depends on the maternal age, diagnosis and the initial male semen analysis and should be discussed with one of our specialists.

For whom ICSI-IVF is recommend for?

It is highly recommended for couples with a history of failed or poor fertilization during standard IVF, as well as men who have:

  • abnormally shaped sperm (poor sperm morphology)
  • slow moving sperm (poor sperm motility)
  • low sperm count
  • anti sperm antibodies (these are produced by the mans body and act
  • any obstruction which prevents sperm release, such as vasectomy
  • anti-sperm antibodies (antibodies produced by the mans body that may hamper with the sperm functionality)
  • an unsuccessful reversal of vasectomy that resulted in poor sperm quality and quantity.


Preimplantation genetic diagnosis (PGD)

PGD is a process in which one or two cells from an embryo on Day 3 or Day 5 are extracted and the cells genetically analyzed. Couples who are at a high risk of having abnormal number of chromosomes or who have an history of single gene defects or chromosome defects are ideal candidates for this procedure. It is used to diagnose a large number of genetic defects at present. We have highly experienced and trained genetic counselors who would meet with you to discuss your genetic issues and your odds of having to do PGD.