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Fertility is an issue that affects many couples all across the world. In the UAE itself, one in every five couples is seeking treatments for infertility. Thankfully, with the ascension of medical technology over the last decade, there are numerous procedures now that allow infertile couples to conceive on their own. One such procedure is called intra-cytoplasmic sperm injection or ICSI. The vast usage of the ICSI process stems from the fact that defective sperm function serves as the primary cause of infertility amongst couples. The reason for defective sperm function could be due to a case of genetics or environmental factors. And ICSI has been the go-to alternative reproductive therapy method in cases with severe male infertility as their cause, or in cases where the male partner did not qualify for a normal IVF due to a lack of motility and normal morphology of their sperm.

Just like other standard fertility treatments, in order for ICSI to commence, fertility drugs are given to the woman to stimulate the ovaries to develop several mature eggs for fertilization. Once the eggs are ready for collection the man and woman will undergo separate procedures. The male partner is asked to produce a sperm sample. If they are not able to do so on their own, the doctor then steps in to extract the sample manually either from the epididymis (PESA) or the testicle (TESA). For practical purposes this procedure is carried out before the treatment cycle begins. The sperm retrieval is then followed by the egg retrieval. In this procedure, the doctor removes the eggs using a fine, hollow needle, attached to an ultrasound probe.

An embryologist then isolates the individual sperm and injects them into the individual eggs. Once the eggs start fertilizing, they now become embryos and are then transferred back into the womb through the cervix, just like in a regular IVF procedure. One complete cycle of ICSI takes about four to six weeks to complete. Despite the higher rate of fertilization that is experienced with ICSI, the pregnancy rate in ICSI is more or less the same as with IVF.

So what exactly are the advantages of ICSI?

  • ICSI gives you and your partner a chance of conceiving your genetic child when other fertility treatments options are unlikely to do so.
  • If your partner is unable to ejaculate on the day of egg collection for standard IVF, sperm can instead be extracted for ICSI.
  • ICSI can also be used to help some couples with unexplained infertility. In this case however, your doctor is likely to initially recommend standard IVF, as ICSI and IVF pregnancy rates are very similar and IVF is a less complex treatment.
  • ICSI doesn’t appear to have any effect on a child’s mental or physical development.

Despite its obvious advantages there some disadvantages associated with ICSI, the first being how expensive it is compared to the normal IVF procedure. And the second being the fact that doctors are still trying to understand the side effects that it may present. However, none of that takes away from the fact the ICSI is a procedure that has helped combat male infertility since the time it first started being used. Without ICSI, there would still be a large number of childless couples in the UAE and across the world.