ICSI in infertility: All from beginning till end

Intracytoplasmatic micro-injection of spermatozoa (ICSI in infertility, for its English acronym) is recommended in cases of male infertility, to facilitate fertilization. Once the spermatozoa are obtained by sperm collection or testicular biopsy, thanks to this process we can select the sperm most suitable for fertilizing the oocytes.

What is ICSI treatment for infertility?
During natural fertilization, the sperm swim and cross the uterus to the fallopian tubes. One of them contains the fertilized egg this month. One of the sperm will penetrate the different layers that protect the egg to fertilize it, and will give rise to a zygote, which will turn into an embryo.

Intra-cytoplasmic sperm injection, better known as ICSI in infertility (after its initials in English intracytoplasmic sperm injection), is an ART technique that involves the direct introduction of a sperm into the egg to facilitate fertilization.

In which cases is ICSI treatment for infertility is recommended?

• Men with low sperm count who have mobility problems or poor body shape.
• Other factors: repeated failures after several cycles of IVF and AI, low number of oocytes after puncture, etc.
• History of failed fertilization.
• Men who have had a vasectomy.
• ART treatments with realization of a Pre-implantation Genetic Test (PGT).
• Infectious disease or infertility caused by immune factors.
• When sperm samples are especially valuable because the quantity is limited. The ICSI in infertility technique optimizes its use:
• Men who perform radio or chemotherapy treatment.
• Patients who have problems getting ejaculate under normal conditions, such as retrograde ejaculation.
• Absence of spermatozoa in the ejaculate. In this case, the sperm can be taken through a testicular biopsy.

ICSI male infertility Results-
The ICSI technique allows the direct union of the ovum and a spermatozoon - selected by our embryologists - while facilitating fertilization. A sperm with low mobility or with a bad morphology would have more difficulty to succeed during natural fertilization or with the classic IVF technique.

ICSI male infertility Procedure-
To perform ICSI, follow a controlled ovarian stimulation to the patient or donor (when using donated oocytes), in order to obtain a good number of eggs with follicular puncture.

Next, we prepare a sperm sample (fresh or defrosted, if we use sperm from a donor. The preparation consists of processing the sample to obtain a portion with the best sperm and activating, in addition, their fertilizing capacity.

Once we have the two gametes, the embryologist performs the ICSI. To do this, he places the samples on a culture slide and, using a microscope and micromanipulators, he selects a spermatozoon, immobilizes it and introduces it using a pipette into the 'ovum. This procedure applies to each of the mature eggs obtained. Thus, we facilitate fertilization as much as possible.

The next day, the embryologist assesses the micro-injected oocytes to see which of them have been properly fertilized (the zygotes). Zygotes remain in culture and give rise to embryos, which are monitored daily. When they have developed, we choose the best embryos: one of them is transferred to the maternal uterus, and the others are vitrified for possible later use.