Intra Cytoplasmic Sperm Injection (ICSI)

Intra cytoplasmic sperm injection (ICSI) involves the injection of a single healthy sperm into the cytoplasm - the jelly-type middle - of an egg.  IVF using the standard insemination technique requires approximately 150,000 sperm for each egg, but ICSI requires just one good quality sperm per egg.

MFS introduced ICSI to the West Midlands in 1994 and it has greatly improved the prospects of parenthood for many couples with specific fertility problems, particularly male factor infertility.

Who may benefit from ICSI?

• men with poor quality sperm
• men who have had surgical sperm recovery because they are azoospermic
• men who have previously provided a sperm sample to be frozen before they received cancer treatment
• couples with previous fertilisation failure from standard IVF insemination
• women using thawed/frozen eggs

ICSI sequence

What does treatment involve?

Following an initial consultation, treatment assessment, follow-up appointment and treatment planning appointment:

• daily injections or a nasal spray (usually naferelin or buserelin) ‘down regulate’ the woman’s usually monthly cycle to a temporary menopausal state in preparation for the stimulation phase of the cycle
• gonadotrophin drugs given by daily injections stimulate the ovaries to produce more eggs than occur in a natural cycle.  An MFS doctor or fertility nurse specialist will advise on the most suitable method for each client
• the dose of stimulating drugs each patient needs is carefully calculated to optimise the chance of pregnancy
• the woman will need to attend the clinic for ultrasound scans during the stimulation phase to monitor the number and size of the growing follicles
• when the follicles have grown sufficiently she will be advised of the day of her egg collection (usually about two weeks after she first starts taking the fertility drugs)
• egg collection is performed with ultrasound guidance under conscious sedation and with pain relief
• the collected eggs are washed and placed in labelled culture dishes before being put into an incubator where the environment mimics the inside of the body
• a nurse - and a partner or friend - will be with the patient constantly throughout the procedure
• where partner sperm is to be used, the sample must be produced at the clinic immediately before egg collection, in a private room at the clinic, close to the laboratories
• around the time of the egg collection an embryologist prepares the sperm for ICSI
• sperm can be taken from a sample produced earlier that day, or from a frozen sample, or from a small sample of tissue (a biopsy) taken from the testis during a surgical sperm recovery procedure
• the best quality sperm are isolated using a sperm filtration system and washed in culture media
• the prepared sperm are then placed in an incubator until it is time for the ICSI injection procedure
• a few hours after egg collection, the follicular cells are carefully removed from around the egg and examined by the embryologist to determine the stage of development. About 70-80% of all collected eggs will be mature and suitable for ICSI injection
• a single sperm with the best shape (morphology) and swimming-ability (motility) is selected and, under a microscope, using a fine glass needle finer than a human hair, is injected into the centre of the egg
• the injected eggs are placed in an incubator and checked the next morning for signs of successful fertilisation - when they become embryos
• the fertilised eggs (embryos) are then cultured before the embryo transfer, two to six days after fertilisation, where one or two of the best quality embryos will be placed into the uterus
• any remaining good quality embryos can be frozen and stored for any future attempts to conceive
• a pregnancy test may be done 14 days after the ICSI embryo transfer to confirm if the treatment has been successful

What is included in the ICSI treatment cost?

• treatment planning
• ultrasound monitoring scans
• teaching how to give injections
• egg collection
• sperm preparation
• ICSI insemination of eggs
• embryo transfer
• embryo freezing and storage for first year (if suitable)
• pregnancy test
• six week scan or follow-up to review the treatment cycle

What is not included in the IVF treatment cost?

• initial consultation or follow-up consultation (as appropriate)
• treatment assessment or repeat screening (as appropriate)
• cost of fertility drugs
• fee for freezing sperm (if required)
• fee for surgical sperm retrieval (if required)
• HFEA levy for the creation in vitro, or transfer of, embryos

How long does ICSI treatment take?

An average of five to eight, weeks from the beginning of the treatment cycle to pregnancy test, depending on the drug protocol.

Costs

Cost of ICSI at MFS: £3,330

Go to the MFS Cost Estimator^©

More information

• Success rates with ICSI

Also, go to the MFS Patient Treatment Information page and download the following infosheets:

• ICSI
• Embryo Transfer Policy and eSET
• Fertility Treatment with Donor Sperm
• Surgical Sperm Retrieval
• Freezing and Storing Sperm