ICSI Treatment
Intracytoplasmic Sperm Injection (ICSI) is a type of IVF treatment that involves injecting a single healthy sperm into a mature egg to help achieve fertilisation. Your fertility specialist may recommend ICSI if there have been challenges with fertilisation in standard IVF and in cases involving male factor infertility.
What is ICSI?
ICSI is a specialised fertilisation technique used as part of IVF treatment. It is often recommended when sperm-related factors, such as low sperm count or reduced motility, make fertilisation less likely with standard IVF. ICSI takes place in a lab as part of an IVF cycle.
Unlike standard IVF, in an ICSI IVF cycle an embryologist will inject a single sperm directly into a mature egg to help achieve fertilisation. In an ICSI IVF cycle, the rest of the treatment process is the same as standard IVF.
Reasons for ICSI
ICSI is recommended when there are challenges with fertilisation or to help overcome male factor infertility.
ICSI treatment may be recommended for:
- Low sperm count (oligospermia)
- Reduced sperm motility (asthenozoospermia)
- High numbers of abnormal sperm (teratozoospermia)
- Elevated levels of antibodies in the sperm sample
- Fertilisation issues in previous IVF cycles
- Infection control for communicable diseases found in semen
Male fertility screening helps assess sperm count, motility and morphology. These results, together with your medical history and any previous treatment, help your fertility specialist determine whether ICSI treatment may be appropriate for you.
What is the difference between IVF and ICSI?
The ICSI Treatment Process
The ICSI IVF treatment process follows the same process as a standard IVF cycle, however the difference is in how the egg is fertilised. In an ICSI IVF cycle the eggs and sperm are placed together in the culture dish and the embryologist carefully selects a single sperm to inject directly into each egg.
Step 1. Ovarian Stimulation
This step involves the use of medication injections such as follicle-stimulating hormone (FSH) to stimulate growth and development of multiple follicles within the ovaries. This step of the IVF process aims to stimulate the ovaries to develop more follicles (which contain the eggs) to produce a greater number of eggs. This means there is more chance of achieving a healthy embryo to transfer back into the uterus.
Step 2. Monitoring
Throughout ovarian stimulation, regular ultrasounds and blood tests are undertaken to monitor the response of the ovaries. Your response will be closely monitored and your fertility specialist may adjust your medications to control the size and amount of follicles. Once your follicles are ready, you will be advised to take your trigger injection to prepare for egg collection.
Step 3. Egg and Sperm Collection
Egg collection takes place around 36 hours after the trigger injection and will be performed by one of our fertility specialists under heavy sedation to collect mature eggs from the ovaries. A fine needle is passed through the vaginal wall and into the follicles within the ovary to aspirate the follicular fluid, which may contain an egg. The number of eggs collected will vary and depends on several factors including age, ovarian reserve and your response to ovarian stimulation.
A fresh semen sample is usually provided on the same day. If surgical sperm retrieval is required, this may involve testicular sperm aspiration (TESA) or an open biopsy, which will generally be performed on the day of egg collection.
Step 4. Fertilisation
With ICSI treatment, one of our highly trained embryologists will use a microscope and specialised laboratory equipment to select a single healthy sperm. This single sperm will be injected directly into a mature egg with skill and precision.
Step 5. Embryo Culture
The following day, our embryology team checks the eggs for signs of fertilisation. Any resulting embryos are monitored as they develop in the laboratory over the following days, typically up to day five, to assess their suitability for transfer or freezing.
Step 6. Embryo Transfer
The embryo transfer involves placing the selected embryo into the uterus. This is done using a thin plastic tube called a transfer catheter which is placed through the cervix and into the uterine cavity before gently placing the embryo in the uterus. This is a simple procedure, similar to a pap smear and does not require an anaesthetic. Any other suitable embryos can be frozen for use in subsequent frozen embryo transfer cycles.
Step 7. Pregnancy Test
A blood test is performed approximately 11 days after embryo transfer to determine whether you are pregnant. Many people find this the most difficult time to endure. While it is filled with hope and excitement, it can also be filled with anxiety. We encourage you to keep busy, eat well and stay hydrated. We will let you know when to have the pregnancy blood test and will talk you through the result and next steps.
FAQs
ICSI is a specialised technique used within IVF rather than a separate treatment. In an ICSI IVF cycle, ovarian stimulation, egg collection and embryo transfer follow the same process as standard IVF. The difference is fertilisation: during standard IVF, eggs and sperm are placed together in the laboratory dish to come together naturally, while ICSI involves injecting a single sperm directly into a mature egg.
ICSI success rates vary based on several factors including female age, egg and sperm quality and underlying fertility conditions. ICSI can significantly increase the likelihood of fertilisation for couples facing male infertility.
ICSI costs vary between fertility clinics. At Adora Fertility, ICSI treatment is bulk billed and costs the same as a standard IVF cycle. A standard IVF/ICSI cycle at Adora Fertility for medicare eligible patients is approximately $2,430 (fees may vary slightly depending on your location).
Some clinics charge separately for ICSI, so it is important to check what is included when comparing treatment costs. Medicare covers some eligible IVF and ICSI expenses, although out-of-pocket costs can still apply.
You can view our current treatment costs or speak with our team for more information about the costs that may apply to you.
ICSI is recommended when male fertility screening identifies sperm-related factors that may affect fertilisation, or when sperm has been surgically retrieved. It may also be considered when previous IVF cycles have resulted in limited fertilisation, or if sperm antibodies are present.
Your fertility specialist will consider your medical and treatment history to determine whether ICSI may be appropriate for you.
ICSI adds a laboratory fertilisation step to IVF, so the treatment risks are mostly those associated with IVF. These include ovarian hyperstimulation syndrome (OHSS) and, when more than one embryo is transferred, multiple pregnancies.
Research has identified a small increase in congenital anomalies among children conceived through ICSI compared with conventional IVF. However, it is not always clear whether this is related to the ICSI procedure itself or other factors associated with infertility and fertility treatment.
You can read more about the possible risks associated with IVF and ICSI. Prior to treatment we will discuss any potential risks with you.
On the day of the ICSI procedure the sperm will be prepared. Under the microscope and using specialist laboratory equipment, the embryologist will inject a single sperm into each mature egg using a fine needle. The following day the embryologist will check for signs of fertilisation.
Any embryos that develop are monitored before a suitable embryo is transferred or frozen for future use.
No. ICSI does not guarantee that an egg will fertilise, that an embryo will develop or that treatment will result in pregnancy or a baby.
ICSI is used when sperm-related factors make fertilisation less likely, but outcomes also depend on age and egg quality. Sperm quality and other individual factors are also important. Your fertility specialist will discuss what you can realistically expect based on your age, egg quality, sperm-related factors and medical history.