Intracytoplasmic sperm injection

For the treatment of couples with male factor infertility and makes paternity possible for a large proportion of men with nonobstructive azoospermia, or no measurable sperm count.

Bypasses natural barriers to fertilization increasing the possibility of transmission of genetic defects from one generation to the next.

ICSI pregnancies associated with 1.5-4 times increased incidence of chromosomal abnormalities, birth deformities, imprinting disorders, autism, and intellectual disabilities compared with conventional IVF.

Unlike conventional fertilization, where approximately 30,000 sperm are dropped onto the egg in a Petri dish, during ICSI, a single sperm is injected into the egg in order to improve the chances of fertilization.

50 to 80 percent of eggs are fertilized using ICSI.

Primarily indicated for men with male factor infertility, accounting for up to one-third of infertility cases.

Male factor infertility problems include:low sperm counts, impaired sperm motility, or shape.

Useful when ejaculate does not contain sperm because of blockage or production problems by extracted of sperm from the testicle.

Useful for men who had a vasectomy or who are without a vas deferens.

Useful with failed fertilization, when more than one sperm fertilizes the egg which makes the embryo unusable, or when the sperm is unsuccessful at fertilizing the egg.

Can be used in pre-implantation genetic testing (PGD), which screens embryos for chromosomal abnormalities or genetic conditions.

Success rates are similar to IVF alone.

Associated with a slightly higher risk for birth defects and chromosomal abnormalities.

A recent study found a 9.9 percent risk of birth defects associated with ICSI, compared to 7.2 percent using IVF.

Birth defects are 77 more likely with ICSI and 26 percent more likely with IVF than with natural pregnancy.

However, severe male factor infertility is a risk factor for the same problems.

More expensive than conventional IVF.

This procedure is most commonly used to overcome male infertility problems, although it may also be used where eggs cannot easily be penetrated by sperm, and occasionally in addition to sperm donation.

ICSI is generally performed following an in vitro fertilization procedure to extract one to several oocytes from a woman.

Procedure perform under a microscope using micromanipulation devices to stabilize the mature oocyte and collect a single sperm and release it into the oocyte.

Live birth rate are significantly higher with progesterone for luteal support in ICSI cycles.

The addition of a GNRH agonist for luteal support in ICSI cycles has been estimated to increase success rates.

Using ultra-high magnification during sperm selection has no evidence of increased live birth or miscarriage rates compared to standard ICSI.

ICSI is safe and effective therapy for male factor infertility, but may carry an increased risk for the transmission of selected genetic abnormalities, either through the procedure itself or through the increased inherent risk of such abnormalities in parents undergoing the procedure.

Infants that result from simple IVF, have no greater risk of birth defects once factors such as the mother’s age and smoking are taken into account.

Birth defects are more common if treatment included injecting a single sperm into an egg, especially if male infertility is involved.

About 10 percent of babies born this way had birth defects versus 6 percent of those conceived naturally.

In addition to regular prenatal care, prenatal aneuploidy screening based on maternal age, nuchal translucency scan and biomarkers is appropriate.

Biomarkers seem to be altered for pregnancies resulting from ICSI, causing a higher false-positive rate.

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