In the past, many couples with moderate to severe male infertility had little chance of creating a genetically related child and often had to turn to a sperm donor.  With the advent of ICSI, it is now possible for men with even severe male infertility to father genetically related children.

One phase of an IVF cycle involves exposing eggs to sperm in a Petri dish, with the goal of achieving fertilization.  When there are very few sperm in the ejaculate, or none at all, fertilization is rare.  Using ICSI, a single sperm is injected directly into each egg. This greatly increases the probability of fertilization.

ICSI is made possible by the use of advanced technologies, including a process called micromanipulation to handle the delicate gametes (eggs and sperm). The eggs are held in place with a micromanipulator while a microscopic needle is used to insert the sperm.  

With ICSI, even men with no sperm in their ejaculate can often create genetically related children.  The sperm are retrieved using either testicular sperm extraction (TESA), where sperm are withdrawn directly from the testicles, or microscopic epididymal sperm aspiration (MESA), where sperm are collected from the epididymis.

Embryologists receive special training to perform ICSI and our team at Baystate Reproductive Medicine has more than 20 years of clinical and research experience. Our ICSI success rates exceed the national average, as reported by the Society for Assisted Reproductive Technologies (www.SART.org).

After many years of clinical use, there appear to be no significant side effects in children whose parents underwent ICSI. Early concerns about possible genetic abnormalities have not been substantiated. However, sometimes the egg may be damaged during the procedure, or fertilization may not be successful.

Some researchers and clinicians have expressed concern that physically selecting and inserting sperm might lead to male offspring with reduced fertility. In nature, the “strongest” sperm usually reaches the egg first and initiates fertilization, whereas in ICSI, a human selects the sperm cell. This impedes the natural selection process. Males born using ICSI are now reaching reproductive age and any reduction in fertility will be documented in the near future. Most clinicians believe these males will not have reduced fertility.

ICSI is a wonderful option for couples with male infertility who wish to have genetically related children.