Birth

Intra Cytoplasmic Sperm Injection (ICSI) is an ART procedure in which a single healthy active sperm is picked up with a fine glass needle and injected straight into the cytoplasm of a mature egg to assist fertilisation.

This treatment is an advanced form of IVF that puts sperm a step ahead as the sperm doesn’t have to travel to reach and penetrate the egg; this improves the chances of pregnancy by making sure the egg is fertilised.

Naturally, prior to a sperm fertilising an egg, the skull of the sperm must connect to the outer surface of the egg. Once connected, the sperm forces itself via the outer surface to the inside of the egg (cytoplasm), where fertilisation happens. Fertilisation is prevented, if the sperm fails to enter the outer surface of the egg, due to some physiological deficiencies, like

egg's outer surface is difficult and/or wide to infiltrate
sperm might fail to float

In these situations, ICSI is performed along with IVF treatment to support egg fertilisation.

Is ICSI for Me ?

ICSI is generally recommended for the couples who have:

Male Infertility

Low sperm count
Poor sperm motility and morphology
Decreased ability of sperm to penetrate the egg
Difficulty in releasing sperm due to an obstruction in reproductive zone

Female Infertility

High levels of antibodies against sperms
Poor egg retrievals, where there are fewer eggs to fertilise

Frozen Eggs or Sperms

Sometimes frozen sperms do not seem active or the eggs become hard (prevent sperm to penetrate) by freezing

Unexplained Fertilisation Failure in Previous IVF Cycles

Low Fertilisation in Previous IVF Cycles

What about the Precaution ?

As ICSI is an improvisation of conventional IVF cycle and is performed simultaneously, the same precautions should be taken as advised for IVF, like

Take medications as prescribed by the treating doctor as these have been prescribed to improve your chances of achieving pregnancy. If you become pregnant you might be asked to continue some of these medications until the 12th week of pregnancy when the body usually starts producing enough.
Avoid smoking and drinking and exposure to cigarettes and X-rays.
Please consult your fertility experts before taking any medication not prescribed by them.

Advantages

Better Genetic Diagnosis

In case of Pre-implementation Genetic Diagnosis (PGD) with IVF, to genetically screen embryos, sperms that have not fertilised the egg also surround the embryo. This can result in inaccurate results of PGD. ICSI ensures that non-participating sperms do not influence the diagnosis.
Similar Success as in IVF

Fertilisation rates, embryo quality and pregnancy rates in those who have had ICSI are identical to those in couples who have had IVF without ICSI.

Risk Factors

in Intracytoplasmic Sperm Injection

Embryo Damage

Not all eggs that fertilise end up in developing into healthy embryos. It may be possible for some embryos and eggs to get damaged during the process of ICSI.
Multiple Pregnancies

Couples using ICSI along with IVF have a 30-35% increased chance of conceiving twins and 5%-10% chances of having triplets. When the mother carries multiples, there are increased risks of certain complications during pregnancy and childbirth, which includes high blood pressure, gestational diabetes, low amniotic fluid levels, premature labor or need of cesarean section.
Birth Defects

There is a 1.5%-3% risk of a major birth defect with normal pregnancy. The risk of birth defects is increased slightly with ICSI treatment, although it's rare nonetheless. Some birth defects are associated with ICSI are Angelman Syndrome, Beckwith-Wiedemann Syndrome, sex chromosome abnormalities and hypospadias.

Also, the risk of a male offspring having fertility issues increases slightly. There is a possibility of genetic transfer of infertility.