Male Infertility::

Microsurgical Fertilization Intra Cytoplasmic  Sperm Injection (ICSI)

Microsurgical fertilization techniques can improve the success rates for couples with a poor pregnancy prognosis when (i) previous IVF was unsuccessful due to the failure of the eggs to fertilize and (ii) when few live spermatozoa can be isolated from the semen.

Although there are two different techniques which may be utilised for microsurgical fertilization - ICSI and SUZI - at the DG&FC the ICSI technique is the treatment of choice, due mainly to its more proven success rate.
 

The ICSI technique is a complicated procedure involving the injection of a single sperm directly into the egg. Each procedure requires the use of tiny delicate glass needles, which are prepared by the experienced embryologist. Each needle must be seven times thinner than a human hair, yet strong enough and sharp enough to penetrate the eggshell.

Using the ICSI technique approximately 60% of the eggs inseminated will be fertilized, where previously the standard IVF technique would not have produced any embryos. 60 % is an encouraging result which allows at least some patients the chance of embryo transfer and possible pregnancy.

There is evidence to suggest that the number of normally shaped spermatozoa found in the semen sample is an important factor when considering the suitability of selecting the ICSI treatment. Also, it would appear that the actual severity of the semen analysis parameters is not related with the outcome of the procedure. Men with poor semen parameters are as successful (or as unsuccessful) as men with moderate sperm abnormalities. The group with the poorest prognosis are those in whom fertilization with regular IVF fails without apparent cause (normal semen analysis), although 30 -60% of the eggs in these patients will fertilize with ICSI, only 15% of them will result in a pregnancy.

The embryos generated from the ICSI technique are cultured in the laboratory for 2-3 days and then transferred into the uterine cavity.

Embryo Hatching

Assisted Embryo Hatching is a laboratory technique, which can assist the embryo in its implantation process and increase the possibility of pregnancy.

Just prior to the placement of the selected embryos into the uterus or Fallopian tube the outer barrier (coat) - Zona Pellucida - of the embryo is gently opened. This makes it easier for the embryo to hatch from and shed the zona before implanting into the uterine wall. Implantation usually occurs four to five days after the embryos have been placed into the uterus.

The hatching can be done mechanically, or by using the more sophisticated and precise laser beam.