Intra – cytoplasmic sperm injection (ICSI)
Intra – cytoplasmic sperm injection (ICSI) differs from conventional in vitro fertilization (IVF) in that the embryologist selects a single sperm and injects it directly into an egg, instead of placing many sperm around an egg in a dish and waiting the egg to be fertilized.
• A very low sperm count
• Other sperm problems such as poor morphology or poor motility
• Failure of fertilization in previous IVF attempts
• When the sperm must be collected surgically from the testicles or epididymis.
• When frozen sperm of bad quality is used.
The patient takes fertility drugs to stimulate her ovaries to produce more eggs.
The progress is monitored during that time with blood tests and vaginal ultrasound scans.
The eggs are then collected and each egg is injected with a single sperm from her partner or donor.
In cases with a zero sperm count , sperm can be collected:
• From epididymis , using a fine syringe . This is known as percutaneous epididymal sperm aspiration or PESA
• From the testicles , a process known as testicular sperm aspiration or TESA.
It is also possible to remove tiny quantities of testicular tissue from which sperm can be extracted. This procedure is called testicular sperm extraction or TESE.