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All About Intra-Cytoplasmic Sperm Injection, Its Procedure & Possible Risks

Dr.Ayushi Bansal 1572 Views
Updated: 19 Jan 2024
Published: 06 Feb 2023
When Does ICSI Become Necessary

Intra-cytoplasmic Sperm Injection Overview

In vitro fertilization is a blessing for those who seek an effective solution to infertility. It is helpful, especially for male infertility issues. Intra-cytoplasmic sperm injection (ICSI) is the best form of in vitro fertilization (IVF). In this process, an embryo transfer after a sperm injection into an egg leads to pregnancy. Experience healthcare professionals administer ICSI which makes it a safe and reliable process.

Intra-cytoplasmic Sperm Injection (ICSI): What Does It Mean?

Infertility is a common problem that makes it challenging for some couples to have a child. The majority of such couples consider undergoing infertility treatment. At present, ICSI is one of the best forms of infertility treatment available for them. In this process, a recipient of ICSI gets a sperm injection which fuses with their egg. It is helpful for the female individual of a couple who cannot normally conceive a child due to the infertility problem of her male partner.

The technical jargon “intra-cytoplasmic” in the name of the treatment refers to the fact that the sperm injection goes to the interiors of the cytoplasm or the central part of an egg. The cytoplasm resembles a gel and it involves salt and water. The very term “intra-cytoplasmic” in the name of the process bears a question in the minds of some people. They wonder if it is the same as in vitro fertilization or a different process. Read on to know more about it.

ICSI vs. IVF: Differences

Though both processes seem to be different on the surface, they are the same. ICSI is a form of IVF but the process that a healthcare provider follows for it is different from that of IVF.

In the traditional process of IVF, a doctor collects thousands of sperm from a dish and places it adjacent to an egg on it. Thereafter, they leave it to fertilize on its own. The egg may or may not fertilize in this process as it depends on chance. On the other hand, the ICSI process involves the direct injection of sperm into the egg which makes it a more reliable process for conceiving a child with guaranteed fertilization.

Other than this difference, the remaining procedure in both processes remains the same. A healthcare provider focuses on the implantation of the fertilized egg into the embryo in both processes. They relate to technology, namely assisted reproductive technology (ART). Both procedures come in handy for addressing the problem of conceiving a child due to male fertility problems. 

Is Intra-Cytoplasmic Sperm Injection Useful?

Along with the rise in the instances of infertility, there has also been a corresponding rise in the need for in vitro fertilization. Today, almost 60 out of 100 IVF procedures relate to ICSI which speaks volumes about its success. It is a successful procedure for addressing the problem of infertility with a 50%-80% chance of success for fertilization.

Who Can Take ICSI?

ICSI is primarily an option to conceive a child for those couples that have a male individual with infertility issues. However, not everyone is an ideal candidate for an ICSI. A healthcare provider recommends when they find the following:

  • Retrograde ejaculation
  • Poor sperm quality
  • Low sperm count
  • Male reproductive system blockage
  • Inability to ejaculate or anejaculation

Additionally, ICSI may be necessary for the following situations:

  • Embryos fail to generate even after undergoing a traditional IVF
  • When the supplier of the eggs is above 35
  • When an individual uses previously frozen sperm

What Happens before, during, and after the ICSI Procedure

Problems in reproduction mostly relate to issues with the endocrine system. Medical doctors who specialize in the treatment of endocrine-related issues are the specialists who treat them thoroughly. Before deciding on administering ICSI, they do a thorough physical examination of an individual’s body (who supplies eggs) and also take the other key aspects of their health into consideration.

Upon deciding to go ahead with ICSI, they retrieve eggs by using the following procedure:

  • Ovulation induction: If you wish to adopt the procedure, your doctor will administer medication injections for 8-14 days to stimulate the production of more eggs through the ovaries. The more eggs your ovaries produce better would be the chances of fertilization. A human chorionic gonadotropin or Lupron will help conclude the maturation of eggs.
  • Egg retrieval: Your doctor will insert a thin needle into your ovaries through your vaginal wall with the help of transvaginal ultrasound technology. They will use anaesthesia to make the procedure painless for you. To collect the eggs, they will use a suction device.

Your doctor may either use frozen sperm or collect it from a donor. If they choose the second option, they will ensure that a sperm donor abstains from ejaculation or masturbation for 2-3 days before the collection of sperm. Next, they will also carry out a semen analysis to analyse the quality and volume of sperm from its donor before injecting it.

While administering ICSI, your doctor will take the following actions in a sequence:

  • Use a pipette
  • Pick up a sperm after immobilizing it with the help of a think needle
  • Reach the cytoplasm by inserting the needle into the egg
  • Supply sperm to the cytoplasm by injecting the former into the latter
  • Take out the needle safely from the egg

After the successful completion of ICSI, your doctor will track the latest developments of the fertilized egg for 5-6 days in a laboratory. This is the usual duration for the formation of a blastocyst through the division of a fertilized egg. Following the formation of a blastocyst, your healthcare provider will analyse its cell mass and size to find out if it is good enough for a pregnancy.

As far as the embryo transfer is concerned, it may either occur on the fifth or the sixth day or your doctor may decide to delay it for a month or several months, or years. At the time of transferring the embryo, your doctor will insert a long and thin tube (also called a catheter) into the uterus to inject the embryo. They will use ultrasound technology to carry it out successfully. The pregnancy happens after the attachment of the embryo to the uterus.

Risks of ICSI

Some common complications due to ICSI include the following:

  • Damage to the eggs due to the penetration of the needle while administering ICSI
  • Prevention of the fertilization of an egg even after the injection of the sperm
  • The lack of development of the embryo even after its transfer to the laboratory

When should you reach out to your healthcare professional?

Reaching out to a qualified healthcare professional becomes essential when you experience some signs due to the ICSI procedure. See your doctor if you either doubt or experience signs of the following:

  • Premature birth
  • Miscarriage
  • Infection
  • Ectopic pregnancy


ICSI is a useful IVF procedure for addressing the problem of conceiving a child. It has a higher rate of success for the fertilization of eggs among the available IVF procedures. However, a female recipient who receives it must know about it thoroughly, including its possible risks, to set up the right expectations as well as to keep themselves prepared for its requirements.

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