Infertility in Men - Treatment

(Page 4)

Highlights	Diagnosis	Resources
Introduction	Treatment	References
Causes	Assisted Reproductive Technologies	Resources
Risk Factors	Lifestyle Changes	References

Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technology used for couples when male infertility is the main factor. It is used in combination with in vitro fertilization (IVF). It involves injecting a single sperm into an egg obtained from IVF. [For more information, see In-Depth Report #22: Infertility in women.]

The procedure is very simple:

A tiny glass tube (called a holding pipet) stabilizes the egg.
A second glass tube (called the injection pipet) is used to penetrate the egg's membrane and deposit a single sperm into the egg.
The egg is released into a drop of cultured medium.
If fertilized, the egg is allowed to develop for 1 - 2 days and then is either frozen or implanted.

text continues below

The greatest concern with this procedure has been whether it increases the risk for birth defects. Many, but not all, studies have reported no higher risks of birth defects in children born using ICSI procedures. However, if the father’s infertility was due to genetic issues, this genetic defect may be passed on to male children conceived through ICSI.

Because several embryos are implanted to increase the chances for pregnancy success, multiple births are frequently an outcome of IVF/ICSI. Multiple pregnancies increase the risks for a mother and her babies. In particular, there is increased risk for premature delivery and low birth weight. These factors can cause heart and lung problems and developmental disabilities in children.

IVF/ICSI can also pose specific risks for the woman. These risks include ovarian hyperstimulation, a condition induced by the fertility drugs used in the procedure. Ovarian hyperstimulation can result in dangerous fluid and electrolyte imbalances as well as increased blood pressure and higher risk for blood clots.

Another concern has been whether the ICSI procedure is being overused. ICSI use has increased 5-fold over the past decade, even though the proportion of men receiving treatment for male infertility has remained the same. Some doctors recommend ICSI for women who have failed prior IVF attempts or who have few or poor-quality eggs, even if their male partners have normal semen measurements. According to the Society for Assisted Reproductive Technology, there is little evidence that ICSI helps improve pregnancy success for couples who do not have a problem with male factor infertility.