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ICSI treatment: a breakthrough in assisted reproduction

Fertility struggles affect one in seven couples across the UK and, in nearly half of these cases, the underlying cause is sperm-related. Fortunately, however, there are effective fertility treatments out there for men that can result in a successful pregnancy.

Intracytoplasmic sperm injection (ICSI), for example, is a groundbreaking male fertility treatment that supports a wide range of sperm-related issues.

In this blog post, we explore what ICSI treatment is, explaining the process of why it works and how successful it can be. Discover all you need to know about ICSI with the Bristol Centre for Reproductive Medicine.

What is ICSI treatment?

ICSI is a male infertility treatment that supports conception by using assisted reproductive technology (ART). This refers to a range of laboratory-based fertility treatments that are used to create an embryo (fertilised egg) outside the human body.

The process of ICSI involves injecting live sperm into an egg in a laboratory to create an embryo. ICSI is carried out using high magnification and a very fine needle – more than 10 times as thin as a human hair.

The term ‘intracytoplasmic’ describes where the injection takes place – inside the cytoplasm of the egg (the substance found within the egg).

Why is ICSI treatment carried out?

ICSI is recommended for couples whose underlying fertility struggles are sperm-related. For example, you or your partner may be advised to undergo ICSI if you:

  • Have a low sperm count

  • Have poor sperm quality

  • Have sperm with slow motility

  • Need to have sperm collected surgically, either because there is a blockage or a production issue

Sometimes, you may be recommended ICSI if the fertilisation rate has been poor at the time of in vitro fertilisation (IVF).

Similarly, you may be advised to use it as a treatment if you are using eggs that have been previously frozen.

The ICSI process: how it works

Before ICSI can be carried out, the sperm and eggs will need to be collected.

During egg collection, follicle-stimulating medication will be given to increase the body's natural production of eggs and provide more eggs for retrieval. An ultrasound scan will also be performed to determine the right time to collect the eggs.

Ideally, a sperm sample will need to be collected on the same day, but this can be done in advance if necessary.

Surgical sperm recovery methods can also be used in cases of ejaculatory issues, blockages or sperm production issues within the testes. Only the best sperm will then be selected to enhance your chances of fertilisation.

Once the sperm and eggs have been collected, the ICSI procedure will be performed in an embryology laboratory. This will involve using a needle thinner than a single human hair to make the injection, while also using high magnification to ensure accuracy.

After the sperm has been injected, the egg will be monitored for signs of fertilisation. This usually occurs within 16 to 18 hours.

If the egg is confirmed to be fertilised, it will be placed in an incubator to continue its embryonic development for up to five days, where an embryologist will monitor its progress throughout.

After the embryo has been cultured, it can then be transferred into the uterus.

How many eggs are fertilised?

While as many eggs as possible will be collected for the ICSI process, not all of them will become fertilised and develop into embryos. However, the more eggs that can be collected, the higher the chance that one or more of them will fertilise.

In general, only one fertilised embryo will be transferred to the uterus. Any remaining high-quality embryos can then be frozen and used in the future if necessary. You can find out more about Embryo Freezing here

How is ICSI different from IVF?

Performed as part of the IVF procedure, ICSI runs in more or less the same way as IVF but with one key difference.

During IVF, thousands of sperm are mixed with unfertilised eggs, so the fertilisation process is entirely down to chance. ICSI, on the other hand, promotes fertilisation by injecting the best-quality sperm directly into the egg.

However, it’s important to remember that, while ICSI may give sperm a higher chance of fertilising an egg, there is no guarantee.

Using different sperm for ICSI

If you are unable to produce high-quality sperm, ICSI can be carried out with a known donor or an unknown donor's sperm instead. The process will essentially be the same except the sperm will not be collected from you.

You should always discuss your options donor sperm with your chosen fertility clinic to ensure they can meet your needs.

See our guide to purchasing donor sperm

How successful is ICSI?

ICSI is considered to be a successful male fertility treatment as it can lead to the successful implantation of an embryo.

At BCRM, our success rates for ICSI are higher than the national average for a wide range of ages, including 35 and under, and 35 and over.

Is the ICSI process safe?

ICSI is a safe procedure to undergo, offering a very low risk of harm to an egg or embryo.

There is a small increased risk of inherited abnormalities in children born after fertility treatments including ICSI, however this is thought to be a result of underlying fertility problems, rather than the treatment itself.

ICSI pricing

The price of ICSI treatment will depend on several factors including what investigations are needed beforehand and what dosage of medications is planned.

Here are some of the example prices you can expect when choosing to have ICSI with us at BCRM:

  • Approximate medication charges per ICSI cycle: £800 to £2,000

  • ICSI procedure per cycle (if required with other procedures): £1,300

However, it’s important to note that these prices will change based on your exact fertility needs. Therefore, it's always worth discussing this in your consultation – that way, we can provide you with a more personalised price.

You can see our price list for more information.

Book a consultation with the Bristol Centre for Reproductive Medicine

ICSI is an effective male fertility treatment that provides many couples with a solution to their fertility problems. By collecting the sperm and injecting it directly into the egg, we can bypass some of the challenges you may have previously faced.

At BCRM, we understand the difficulties that fertility struggles can bring. The complex journey couples face when trying to conceive is something we specialise in and work to make easier.

If you and your partner are struggling to conceive, get in touch with BCRM. Our dedicated team of fertility specialists are on hand to provide you with the support and advice you need.