What is ICSI and why is it so important in the IVF cycle?

Sher Fertility Institute New York’s fertility expert, Sergio Oehninger, MD, PhD,  gets many questions about what ICSI is what it has to do with fertility.  This is blog, he will help you to understand the importance of it so that you can start your journey to parenthood well informed.

 Intracytoplasmic sperm injection or ICSI is a microsurgical technique in which a single sperm is injected into harvested mature eggs in an IVF cycle using a microfertilization needle.

ICSI was developed in the mid 90’s. Before that, in all IVF cases eggs were inseminated in a Petri dish with very high numbers of sperm to try to achieve fertilization. Typically, we needed half a million motile sperm per egg to be successful. Consequently, in the early IVF days, couples with male infertility (low sperm count, low motility, poor morphology) were at risk of no fertilization (total failure or low rates). Some couples with unexplained infertility also had this negative outcome.

Since the inception of ICSI, the rate of fertilization of mature eggs in all good laboratories has been 75% across the board! Since the technique is safe and reproducible, ICSI is now the standard “insemination” method in the lab.

Importantly, scientific efforts have led to the utilization of novel sperm selection methods to use for ICSI. The single spermatozoon injected into an egg is selected by methods that separate the sperm with highest motility and best morphology. Additionally, at the Sher Institute we have integrated PICSI to aid in sperm selection. Some men with poor sperm parameters have an increased number of sperm with DNA fragmentation. This can be due to infections, oxidative stress and many other causes. Our andrology laboratory uses a Halotest to identify those men. If the rate of sperm DNA fragmentation is over 20% of the studied population, PICSI is used. In PICSI, microbeads coated with hyaluronic acid bind sperm that have lower degrees of DNA fragmentation, and consequently PICSI offers another level of safety and increased success.

If you want to discuss this in further detail with any of our fertility experts or have any questions you would like to ask and would like a consultation, contact Sher Fertility Institute New York at 646-792-7476 or click here to schedule an appointment.