Assisted Reproductive Technologies or ART

There are many advanced procedures used by fertility specialists to help couples achieve pregnancy and they fall under the heading of "assisted reproductive technologies" or ART. Procedures such as in vitro fertilization, preimplantation genetic diagnosis (PGD) and donor egg IVF, as well as the various procedures employed to remove sperm from the male reproductive tract, qualify as ART.

Since the 1980s there has been a virtual explosion of techniques and new technologies in reproductive medicine. Couples who previously had no hope of conceiving have been enabled, through ART, to create a genetically related child of their own. Among these new technologies is one called intracytoplasmic sperm injection or ICSI.

Intracytoplasmic Sperm Injection-Sounds Rather Extreme

ICSI is very similar to conventional in vitro fertilization in that eggs and sperm are collected from each partner. Where these procedures differ is in the way fertilization is achieved. In the regular IVF procedure, the eggs and sperm are combined together in a dish and the sperm fertilizes the egg in something of a natural way. In order for this method to be effective, there must be a large number of actively swimming normal sperm available. For some couples, this is not possible due to a limited number of suitable sperm available or some other reason. Conventional IVF is therefore not an option.

The Difference Between IVF And ICSI

Enter ICSI, which gives new hope to such couples. With ICSI, an experienced embryologist using specialized equipment in a laboratory picks up a single sperm with a glass needle and injects it directly into the egg. This assisted reproduction technique does not require a large number of sperm nor does the sperm have to penetrate the egg-that is done by the glass needle. There is no guarantee that ICSI will work since it is still necessary for the normal chain of cellular events of fertilization to take place once the sperm is in the egg.

Who Is A Candidate For ICSI?

Just as with IVF, the criteria for an ICSI treatment cycle include circumstances when the sperm count is very low or is impaired in motility or abnormal in some other way. ICSI is employed when sperm has to be surgically retrieved or following electro-ejaculation. When there are high levels of antibodies in the semen or previous IVF treatments have failed, then ICSI becomes an option.

What Are The Risks?

The ICSI treatment cycle is exactly the same as an IVF treatment cycle. There are risks associated with ICSI which include stimulation of the ovaries in order to encourage development and maturation of eggs and the subsequent retrieval of the eggs. Egg fertilization and culture of the embryos as well as the transfer of the embryo back into the womb can present risk also.

Success varies, particularly when it comes to the age of the woman. However, about 25 percent of those treated will have a baby after one attempt of ICSI.


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