The instigation of Intracytoplasmic Sperm Injection (ICSI) in fertility treatment has made it possible to distinctly fertilize the eggs with the sperm derived from men to correct male infertility factors. The pregnancy rates obtained by using this fertilization method are high than the conventional IVF executions in cases of non-male-factor infertility.
ICSI includes direct injection of sperm into eggs under the direct vision of microscope. It provides a high level of technical expertise to track the fertilization process. As a matter of fact, during the absence of sperm in the ejaculation, ICSI is performed with sperm that is obtained through Testicular Sperm Extraction (TESE), or aspiration (TESA).
It happens usually in the following cases:
- This syndrome refers to the situation of congenital absence of the Vas deferens where a man is born without any of the major sperm collecting ducts
- In the case where the vasa deferentia are obstructed. Vasa deferentia are the ducts, which transfer the sperm to the urethra from the testicles for ejaculation. It can happen due to the effects of vasectomy or trauma
- In cases of testicular failure or when the man is suffering from impotence
The birth rate has usually no difference when IVF is performed for any fertility indications other than factors of male infertility.
In case ICSI treatment is performed for indications apart from male infertility there is:
- Restricted risk of successive embryo chromosome deletions
- Complete control over incidences of miscarriages
- Zero increase in birth defects
- Restricted infertility in the resulting male offspring
Then also there are no drawbacks in performing ICSI on all patients undergoing IVF. There are various reasons that reveal why there is a strong practice of performing ICSI, regardless of the fact that there is proven sperm dysfunction.
First of all, it is directed in all cases of male infertility. Secondly, if we understand it better, the procedure of ICSI is not responsible for causing complications, rather the indication for which the technique of ICSI is executed.
Hence, the execution of ICSI procedure should be an acceptable policy. We have discussed a few points to support this position:
- The IVF procedure is related to unanticipated absence or lower fertilization in 12 to 15% of infertility cases. If truth be told, recent tests related to sperm function like the Sperm Chromatin Structure Assay (SCSA), have disclosed the fact that factors of DNA damage can exist in sperm obtained from men with normal as well as abnormal semen analyses. Beyond a doubt, the male infertility factors present in such cases is not affected by normal or abnormal analysis of semen. Forced eggs fertilization performed under ICSI helps intended parents to avoid disappointments related to unanticipated failed fertilization, which can otherwise occur in such cases.
- Fertilization of eggs in the Petri dish is performed by an interaction between sperm and the cumulus cells surrounding the egg. In various IVF procedures, no need of removing the surrounding cumulus cells is noticed to examine its structure and maturity. It also is not required to prepare the embryo for Preimplantation Genetic Screening (PGS). If the cumulus cells are removed, the egg is found to be less capable of getting spontaneously fertilized. Hence, ICSI is considered to be mandated in such cases.
- In every medical case related to infertility, in both male and female, ICSI obstructs most chromosomal dysfunctions and eliminates almost all the barriers to fertilization. In case there is still a failed fertilization in spite of ICSI, there is a greater possibility of genetic/chromosomal causes underlying and, thus, makes ICSI even more compelling.
IVF vs. ICSI- Busting Some Myths
ICSI is the only option of fertility treatment in case of male infertility. However, several IVF experts may revolve around the question of which technique of infertility correction to be used in case the man has normal sperm counts. This is when people begin to contemplate the pros and cons of IVF and ICSI. Let us discuss some of the very common misunderstandings related to ICSI:
The actual fact is that both these fertility treatments have been offering good success rates to Intended Parents. The primary reason behind this is the similar rate of embryo implantation in IVF and ICSI techniques. Both these procedures have mastered in producing the best quality embryo. As long as there is a healthy embryo, it can be successfully transferred to initiate a healthy pregnancy and delivery.
Certain embryologists of conservative school of thought consider ICSI to be effective for the offspring’s fertility in case it comes out to be a male. Detailed research on this subject has ruled out such notions and there is almost no fertility treatment technique more successful than ICSI that treats male infertility.
Millions of successful procedures conducted in IVF and ICSI have proved that these fertility correction techniques have brought rays of hopes to countless childless parent’s lives. None of these procedures are harmful in any way for the carrier or the offspring. ICSI is a more used technique to directly infuse the strongest sperm in the egg individually to bring out the best fertilization results.
There is absolutely no increase in the risk of birth defects in the resulted offspring post-ICSI. As a matter of fact, men suffering from azoospermia because of Y-chromosomal micro-deletions and men who choose ICSI for their infertility correction both have male offspring with a similar type of micro-deletion. Nonetheless, a man with normal chromosomes going for kids after ICSI treatment is going to have babies with absolutely normal chromosomes. The procedure of ICSI itself doesn’t cause any sort of genetic problems.
The success rates of both IVF and ICSI are equally good. Couples are advised to go for either IVF or ICSI based on their particular case. The couple has to undergo a series of medical fertility tests to ascertain the fertility treatment that would benefit them the most and accordingly the procedure is chosen and applied.