What is ICSI?
- ICSI stands for Intracytoplasmic Sperm Injection. IVF with ICSI starts with egg collection and then involves injecting a single sperm into the center of each mature egg, to help fertilization to occur.
- The resulting embryos are transferred to the female womb in the same way as in a conventional IVF cycle. The extra embryos that are not transferred in this cycle can be frozen for the future use.
Who needs ICSI?
ICSI is used, in synchronicity, with an IVF cycle when fertilization is unlikely to occur using conventional IVF.
Most commonly, ICSI is appropriate when there is a male factor to your infertility. ICSI is mainly used in the following case:
- The number of sperm is low.
- The sperm motility (movement) is poor.
- There is a high number of abnormal sperm.
- The sperm has been collected surgically.
- There are high levels of antibodies in the semen.
- There have been past unexplained failures to achieve fertilization in conventional IVF, or when very few eggs have fertilized following IVF.
- Sperm function tests have revealed that the sperm would be questionable to achieve fertilization, or embryo quality and implantation may be compromised.
- Donated gametes are being used.
What is the necessary treatment procedure?
ICSI process involves the following steps:
- The mature egg is held with a particular holding pipette.
- With a very fine, sharp and hollow needle, a single sperm is collected.
- Then the needle is delicately inserted into the shell of the egg (zona) and the cytoplasm (center) of the egg.
- The sperm is implanted into the cytoplasm, and the needle is removed.
- The eggs are examined the next morning for any evidence of regular fertilization.
What is IMSI?
- IMSI stands for Intracytoplasmic Morphologically Selected Sperm Injection.
- The IMSI process requires the evaluation of sperm, at very powerful magnification, utilizing an inverted microscope.
- The digitally enhanced lens presents a much greater magnifying power compared to the one usually used in ICSI.
- This highly-magnified view enables us to identify subtle sperm defects that are not visible with a conventional ICSI microscope.
- The embryologists examine defects within the sperm as well as checks for more familiar shape, size, and motility abnormalities.
- Once selected, the sperm is introduced into the egg in the same way as with the standard ICSI procedure.
Who needs IMSI?
The following patients can benefit from IMSI:
- The men with elevated levels of DNA fragmentation.
- When there have been reoccurring miscarriages.
- Where implantation hasn’t worked on several occasions following the ICSI treatment.
- Where preceding, embryos have developed unsuccessfully.
- Male factor infertility – a high number of abnormal sperm.
What is TESA/TESE?
- During your semen analysis, if it shows that you don’t have sperm within your ejaculate, there are various techniques of surgically retrieving the sperm, which is known as Surgical Sperm Retrieval (SSR).
- In such a case the sperm is retrieved from the tissue in a man’s testis using one of the two SSR methods – Testicular Sperm Aspiration (TESA) or Testicular Sperm Extraction (TESE).
- Testicular Sperm Aspiration (TESA) transpires when a fine needle is inserted into the tests and specimens of tissue carrying sperm are obtained by gentle suction.
- Testicular Sperm Extraction (TESE) involves taking a biopsy (tissue sample) through a small incision in the scrotum.
- These procedures are minor day operations and should be performed before beginning an IVF cycle.
Who needs TESA/TESE?
- If you have no sperm in the ejaculate due to poor sperm production. The problem may be because of previous testicular surgery, prior medical treatment, or a genetic problem.
What is Micro-TESE?
- Micro-TESE also known as Microsurgical Sperm Retrieval is the retrieval of sperm from the testicle.
- The procedure involves an operation performed through a small midline incision in the scrotum, through which one or both testicles.
- The doctor then conducts a careful examination of different areas of the testicles to check for any abnormalities and to identify the presence of sperm.
- This procedure is usually performed only if all other Surgical Sperm Retrieval (SSR) techniques have been unsuccessful.
Who needs Micro-TESE?
- This method is usually used if you don’t have any sperm within the ejaculate due to reduced sperm production, or if other SSR techniques have been unsuccessful.
- The reduced sperm production may be the result of previous testicular surgery, a genetic problem, prior medical treatment, or other male factor infertility issue.
What is PESA?
- PESA also known as Percutaneous Epididymal Sperm Aspiration is a Surgical Sperm Retrieval (SSR) method.
- It is a method in which the sperm is retrieved by a gentle suction after a fine needle is injected into the epididymis, above the testis.
- This procedure is usually conducted when the ejaculate has no sperm because of an injury, blockage or previous surgery.
- PESA is generally performed before starting an IVF cycle, and the extracted sperm is frozen and stored for use in conjunction with Intracytoplasmic Sperm Injection (ICSI) during your IVF cycle.
Who needs PESA?
- This fertility treatment is usually suitable if you do not have any sperm within the ejaculate, due to a blockage of some kind.
- The problem may be because of previous surgery, such as a vasectomy.