Couples with severe male factor infertility (low concentration or motility, high abnormalities or positive antisperm antibody binding) or those who have had repeatedly low or no fertilisation with conventional IVF are offered intracytoplasmic sperm injection (ICSI). This treatment has been a major step forward in assisted reproduction technology. In simple terms, ICSI is an extension of IVF and works by bypassing the need for the sperm to penetrate the egg.
Following egg collection the mature eggs are specially treated to remove the cumulus cells surrounding them. A single sperm is selected and drawn up into a very fine, specially prepared glass needle. The embryologist then injects this sperm directly into the egg under microscopic control using specialised instruments.
Once injected, the eggs are placed in an incubator until the following morning before being examined for signs of fertilisation (day 1). Despite ICSI being implemented to help increase the chance of fertilisation unfortunately it cannot guarantee it.