How ICSI Adaptions Improve IVF?

Infertility conversations often incorrectly only focus on female factor infertility. However, in heterosexual couples, the research suggests that both genders can equally contribute to difficulties in conception. For men, the biggest issues tend to center on sperm quality or physiological issues that are preventing a couple from getting pregnant naturally. When such issues arise, in vitro fertilization (IVF) is one of the most effective methodologies for overcoming male factor infertility. However, when there are more complex underlying causes, adaptations may be necessary. Specifically for severe male infertility, the primary goal. However, when complex male factor fertility issues exist, intracytoplasmic sperm insemination (ICSI) can be the solution.

Who ICSI helps

ICSI is a very specific fertilization method that’s designed especially for men struggling with achieving or maintaining an erection, but who have impaired sperm quality. For example, individuals with blockages preventing semen from leaving the body would be ideal candidates for this IVF adaptation. Similarly, participants with low sperm count or poor motility would also benefit from adding ICSI to a round.

Understanding the process

The ICSI step solely focuses on inserting a single healthy sperm into an egg harvested during the egg retrieval process in IVF. However, depending on the severity of a man’s infertility, a variety of methods might be used to extract semen. For a man who can achieve an erection, manual collection is always an option. If an erection isn’t possible, fertility specialists might recommend undergoing one of two extraction techniques. Testicular sperm aspiration (TESA) is a process in which a needle is inserted into the testicle to remove a small bit of tissue or fluid to collect sperm. Conversely, microsurgical epididymal sperm aspiration (MESA) is a procedure in which an incision is made to manually remove fluid from the epididymis, which normally contains mature sperm. Once the sperm is collected, a technician will then insert one sperm into the egg rather than introducing several specimens to the ova, and monitor for fertilization.

Does ICSI extend IVF timelines?

Since many of IVF’s modifications occur during the lab-based fertilization stage, timelines are not significantly extended. With ICSI, couples will still expect to spend between 4-6 weeks in a full IVF cycle. The only variation is during the fertilization window, when a single sperm is inserted into an egg rather than simply having a cleaned semen sample introduced to multiple eggs to foster embryo development. When timelines are extended, the main cause is usually due to requested genetic testing or if a couple is using previously frozen embryos.

Choosing the best option

IVF is an incredibly flexible fertility treatment that can be modified with a variety of adjustments depending on the underlying infertility issues that might be present. The method is ideal for tackling both female and male factor infertility, with processes like ICSI that can attempt to correct known issues. However, couples considering IVF who are dealing with male factor infertility are urged to speak with a fertility specialist to learn more about the IVF process and how ICSI can help.