Abbie Tomson
Midwife MSc, BSc, Yoga Teacher, Project Lead at All4Birth
@enevlorel @All4Birth
Summary
In the journey of starting a family, many couples face challenges that can make conception difficult. One advanced form of assisted reproductive technology (ART) that has helped countless couples achieve their dream of parenthood is Intracytoplasmic Sperm Injection (ICSI). This article delves into the specifics of ICSI, its success rates, and what couples in the UK can expect when considering this option.
What is ICSI?
ICSI is a specialised form of in vitro fertilisation (IVF) used primarily for male infertility. Unlike traditional IVF, where multiple sperm are placed near an egg in hopes that one will fertilise it, ICSI involves the direct injection of a single sperm into the egg. This method bypasses many of the natural barriers to fertilisation, offering hope to couples with severe male factor infertility or those who have had unsuccessful IVF attempts.
Who Can Benefit from ICSI?
ICSI is particularly beneficial in the following scenarios:
- Severe Male Infertility: When the male partner has low sperm count, poor sperm motility, or abnormal sperm morphology.
- Previous IVF Failures: Couples who have had multiple failed IVF cycles with poor fertilisation rates.
- Frozen Sperm Use: When using previously frozen sperm, it might have lower motility.
- Unexplained Infertility: Sometimes recommended when no clear reason for infertility is identified.
The ICSI Procedure
The ICSI process follows several steps:
- Ovarian Stimulation: The female partner undergoes hormonal treatments to stimulate the ovaries to produce multiple eggs.
- Egg Retrieval: Eggs are collected using a fine needle from the ovaries under ultrasound guidance.
- Sperm Collection: A semen sample is obtained from the male partner.
- Sperm Injection: A single sperm is injected directly into each mature egg using a fine glass needle.
- Embryo Culture: The fertilised eggs (embryos) are cultured in the lab for several days.
- Embryo Transfer: One or more healthy embryos are transferred to the uterus.
Success Rates of ICSI
Success rates for ICSI can vary based on several factors, including the age of the female partner, the quality of the sperm, and the expertise of the fertility clinic. According to the Human Fertilisation and Embryology Authority (HFEA), the UK’s independent regulator of fertility treatment, the average birth rate per ICSI cycle for women under 35 is approximately 31% as of the latest data. This rate decreases with age, with women aged 35-37 having a success rate of around 25%, and women aged 38-39 seeing a success rate of about 19% per cycle.
Risks and Considerations
While ICSI has revolutionised the treatment of male infertility, it is not without risks:
- Multiple Pregnancies: If multiple embryos are transferred, there is a higher chance of twins or triplets, which can pose health risks to both the mother and babies.
- Ovarian Hyperstimulation Syndrome (OHSS): A potential side effect of the hormonal treatments that stimulate the ovaries.
Making the Decision
Deciding to undergo ICSI is a significant step. Couples should consult with a fertility specialist to understand their specific circumstances and the potential benefits and risks. In the UK, many clinics are HFEA-licensed and offer high standards of care, ensuring that couples receive the best possible guidance and treatment.
Conclusion
ICSI offers a beacon of hope for many couples struggling with infertility, particularly those facing severe male factor infertility. With success rates continually improving and advancements in reproductive technology, ICSI remains a vital option for those looking to start or grow their families. Couples considering ICSI should seek out comprehensive advice from trusted fertility clinics to make informed decisions tailored to their unique situation.
For more information and support, couples can visit the HFEA website or consult with local fertility experts who can provide personalised guidance on their journey to parenthood.
Links to other resources
Books
BooksBrain Health from Birth: Nurturing Brain Development During Pregnancy and the First Year by Rebecca Fett
Real Food for Pregnancy by Lily Nichols
Functional Maternity: Using Functional Medicine and Nutrition to Improve Pregnancy and Childbirth Outcomes by Sarah Thompson
IVF: A Patient’s Guide to IVF and How to Maximize Your Chances of Success” by Rebecca Matthews
Film Audio and Apps
Film Audio and AppsBaby Buddy app, created by the Best Beginnings Charity
WebsitesReferences
- Human Fertilisation and Embryology Authority (HFEA). (n.d.). Fertility treatment 2019: Trends and figures. Retrieved from https://www.hfea.gov.uk/about-us/publications/research-and-data/fertility-treatment-2019-trends-and-figures/
- Human Fertilisation and Embryology Authority (HFEA). (n.d.). ICSI (Intracytoplasmic Sperm Injection). Retrieved from https://www.hfea.gov.uk/treatments/explore-all-treatments/icsi/
- Palermo, G., Joris, H., Devroey, P., & Van Steirteghem, A. (1992). Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. The Lancet, 340(8810), 17-18. https://doi.org/10.1016/0140-6736(92)92425-F
- Devroey, P., & Van Steirteghem, A. (2004). A review of ten years experience of ICSI. Human Reproduction Update, 10(1), 19-28. https://doi.org/10.1093/humupd/dmh006
- HFEA. (n.d.). IVF success rates. Retrieved from https://www.hfea.gov.uk/choose-a-clinic/clinic-search/results/
- Centers for Disease Control and Prevention (CDC). (2020). Assisted reproductive technology (ART) success rates. Retrieved from https://www.cdc.gov/art/artdata/index.html
