Assisted Conception Services
Nuffield Health Woking Hospital
Centre no: 0144
PATIENT INFORMATION LEAFLET
ICSI
This information leaflet is in addition to the
IVF PATIENT INFORMATION LEAFLET
WHAT IS “INTRACYTOPLASMIC SPERM INJECTION” (ICSI)?
The ICSI technique is a way of helping a sperm to fertilise an egg, and it can be used
when we are concerned that routine IVF fertilisation will not work. ICSI overcomes
some of the barriers to fertilisation but it does not guarantee that an egg will
fertilise. The development of ICSI means that as long as some living sperm can be
obtained (even in very low numbers), fertilisation is possible.
An egg being injected during ICSI
WHO NEEDS ICSI?
We perform ICSI when there is a reason to worry that routine IVF will give poor or no
fertilisation. We can predict who may need ICSI by doing a semen analysis before the
treatment cycle, and by looking at the results of the semen preparation. Any men
who have their sperm retrieved surgically will require ICSI.
In other cases, the fertilisation rate following a cycle of IVF may be disappointing
and in those cases the patients can benefit from ICSI in a later treatment cycle. ICSI
cannot be used to ‘rescue’ eggs the next day if they have not fertilised by routine
IVF.
WHAT HAPPENS DURING ICSI?
The eggs are collected, and on the same day the sperm is prepared just as in routine
IVF. Later the same day, the embryologist will prepare the eggs for ICSI and will see
Assisted Conception Services
Pt information - ICSI
Authorised by: Mr A Riddle PR
Reviewed by: C Pretty Senior Embryologist
C Lewis ACU Manager
Version 5
First issued: Feb 2006
Page 1 of 2
Next review: Feb 2016
Assisted Conception Services
Nuffield Health Woking Hospital
Centre no: 0144
how many of them are mature. They will then select a single sperm to inject into
each of the mature eggs. Only eggs which are mature can be used for ICSI.
ARE THERE ANY RISKS TO THE EGGS DURING ICSI?
The piercing of the egg during ICSI may lead to damage, and this will be seen either
during or after the procedure. These eggs cannot be used in treatment. The rate at
which eggs are lost in this way can vary, but in our unit this rate is approximately 3%.
WHAT ARE THE RISKS ASSOCIATED WITH ICSI TREATMENT?
ICSI has been performed in thousands of fertility clinics around the world, since it
was first introduced in 1992. At the Victoria Wing, approximately half of our patients
have ICSI, and the results are just as successful as IVF, with hundreds of healthy
babies born. However the children born from ICSI are now only reaching their
adulthood and of course we cannot know what may be found as these people reach
maturity and have children of their own, or when they reach old age.
Risks that may be associated with ICSI include certain genetic and developmental
defects in a very small number of children born using this treatment. However,
problems that have been linked with ICSI may have been caused by the underlying
infertility, rather than the technique itself.
There may be an increased risk of miscarriage because the technique uses sperm
that would not otherwise have been able to fertilise an egg.
A low sperm count caused by genetic problems could be passed on to a male child,
so in some cases we recommend genetic tests before performing ICSI. Infertile men
with low sperm count or no sperm in their ejaculate may be tested for cystic
fibrosis genes and for chromosome abnormalities. You may want to discuss the full
implications of taking these tests with your clinician or the clinic’s counsellor
before going ahead.
Assisted Conception Services
Pt information - ICSI
Authorised by: Mr A Riddle PR
Reviewed by: C Pretty Senior Embryologist
C Lewis ACU Manager
Version 5
First issued: Feb 2006
Page 2 of 2
Next review: Feb 2016