Male Infertility Treatments

Intracytoplasmic Sperm Injection (ICSI)

ICSI - it sounds like a spy organization or a government agency, doesn't it? In fact, intracytoplasmic sperm injection (ICSI) is one of several options of male infertility treatments available today. Developed within the past decade, this treatment has changed the way male infertility is being managed. Most infertility treatments are centered on women, but things are changing.

How It's Done

ICSI is a type of in vitro fertilitzation (IVF) procedure most commonly used to overcome male fertility issues wherein a single sperm is injected directly into an egg. This procedure is done under a microscope using a variety of devices specially designed for microscopic manipulation. Micromanipulators, microinjectors and micropipettes are employed in the fertilization of the oocyte, or egg. The egg is stabilized by a holding pipette, a type of instrument which enables the surgeon to keep the egg in place during installation of the sperm. A thin, hollow needle which is loaded with a mature sperm is inserted into the inner part of the egg and then the sperm is released into the egg. Afterward, the oocyte is placed into a cell culture and is checked within 24 hours for signs of fertilization.

Utilizing Natural Methods

During the course of natural fertilization the sperm compete for position and once the first sperm makes an entrance into an egg cell, the egg cell then blocks any other sperm from entrance. There has been some concern sighted that this natural selection process is being tampered with by the embryologist who selects the mature sperm without testing. Since then, the FDA has cleared a special device which allows for the selection of mature sperm through a method based on sperm binding to hyaluronan, the main factor in the layer of gel which surrounds the egg. This new device places a drop of hyaluronan into culture dish and the mature sperm is captured when it binds to the drop. Research has indicated that the sperm which adhere are in fact more mature and have fewer DNA strand breaks and much lower levels of aneuploidy - cells with fewer or more chromosomes than usual - than the other sperm within the sperm pool.


Most methods of IVF indicate an increase in birth defects, and ICSI has been specifically addressed in this matter. However, newer technology has been developed which hopefully will change this situation and lower the apparently elevated levels of birth defects associated with ICSI.