Abnormally low counts or absence of sperm in the ejaculate is no longer a life sentence. ICSI or Intracytoplasmic sperm injection now offers couples in this dilemma renewed hope of having children of their own. This could be your opportunity too! ICSI is a relatively new, but well established procedure. It was first performed in Belgium in 1992.

I. Couples who have abnormal sperm parameters i.e. low counts, poor motility, abnormal forms.

II. People with total absence of sperms (azoospermia)

III. Couples who have had difficulties achieving fertilization after conventional IVF

IV. Couples who are using cryo preserved sperm samples which are limited in number and quantity.

ICSI involves injecting a single sperm, into the cytoplasm of each egg using a fine glass needle. The ability of the sperm to penetrate the egg is no longer an issue, as this is done as part of the procedure. It should however be remembered that ICSI though useful for achieving fertilization still requires good quality eggs.

Couples go through the same preparation process as in conventional IVF, namely ovulation induction and egg collection; the only difference being the way the eggs and sperm are treated in the laboratory.

Sperm collection can be from ejaculate, or aspirates from the epididymis (PESA) or testes (TESA). Sperms preparation may also be obtained from frozen semen sample or testicular tissue. ICSI does not increase the incidence of multiple pregnancies as compared to conventional IVF.

The outcome of IVF treatment has been found to vary with the cause of infertility. Couples with sperm problems alone have a higher chance of achieving pregnancy in contrast to those with tubal problems.