Assisted Fertilization Using ICSI（ICSI）
ICSI is first performed in Belgium in 1992 and is currently the most common procedure used for assisted fertilization. It is performed by embryologists trained in this technique. A single motile and normal-appearing (morphology) sperm is selected under the microscope using 400× magnification and injected directly into an egg (oocyte cytoplasm or ooplasm). Because ICSI overcomes natural barriers that prevent fertilization, there is a concern that undesirable genetic traits from infertile men may be transmitted to their offspring. Indeed, studies have suggested that there is a higher risk of birth (particularly genitourinary) and epigenetic defects (such as Beckwith Wiedemann) in children conceived by ICSI.
Studies to date support the safety and efficacy of ICSI in the treatment of male factor infertility. ICSI is also beneficial for couples with:
- Surgically retrieved sperms,
- Cryopreserved oocytes,
- Undergoing pre-implantation genetic testing and
- Prior fertilization block with conventional in vitro fertilization.
In recent years, ICSI is increasingly applied for non-male factor infertility such as advanced maternal age, low oocyte yield, unexplained infertility and for routine use to avoid fertilization block or failure. The latest report (2016) from the International Committee for Monitoring Assisted Reproductive Technology showed that ICSI was used in 65% of IVF cycles in Europe and up to 100% in some parts of the world such as Arabian countries. The data to support such indications is flimsy and at best, equivocal.
