Intracytoplasmic sperm injection (ICSI) is an In Vitro Fertilization procedure in which a single sperm is injected directly into an egg in order to achieve fertilization. This procedure is most commonly used to overcome male infertility although at La Jolla IVF we have found ICSI to be a very effective method to secure fertilization of eggs in the IVF lab.

In the early 1990’s the ICSI technique was developed for male factor infertility and as a remedy for male infertility, ICSI has revolutionized infertility treatment. Before the advent of ICSI, the only options for men with poor semen parameters were to use donor sperm or to adopt. ICSI is so effective that we have had many cases where we have had less sperm to work with than eggs available and we were still able to help those couples have a family.

The ICSI procedure:
Once mature eggs have been obtained from the female the ICSI procedure is performed under a microscope using multiple specialized micromanipulation devices (micromanipulators, microinjectors and micropipettes) that enable the embryologist to select and then pick up individual sperm in the tiny, hollow ICSI needle. Once loaded with the single sperm, the hollow needle is pierced through the outer shell of the egg and egg membrane and the sperm is injected into the cytoplasm of the egg. After the procedure, the injected oocyte will be placed into cell culture inside an incubator and checked approximately 18 hours later for signs of fertilization.

Who should be treated with ICSI:
There is still debate amongst the infertility community as to exactly which cases should incorporate the ICSI procedure with IVF and which cases should use the older conventional method of fertilization whereby the egg is placed in the Petri dish surrounded by sperm and hopefully fertilization will take place unaided.

Over time, our thinking has evolved to the point where we use ICSI in all our cases so that we can maximize the number of embryos obtained per case. In our hands, using ICSI, we are securing fertilization rates of greater than 80% and therefore we believe this excellent fertilization rate warrants the use of ICSI in all of our cases. At La Jolla IVF no additional fees are charged for ICSI because we consider ICSI to be a necessary adjunct of the IVF procedure in order to fully maximize the success of the cycle.

Suffice to say, fertilization by ICSI is one of the major breakthroughs in infertility treatment and has enabled thousands of children to be born around the world who would otherwise not be here.