In the world of Assisted Reproductive Technology, ICSI, or IntraCytoplasmic Sperm Injection  continues to have a significant role to play in the lives of so many couples facing infertility, especially when it comes to male factor infertility. ICSI has become so popular that it is being used by 66.5% of the fertility centres in the present time. The reliability that ICSI provides in cases of severe male infertility factors, advanced maternal ages, and low oocyte maturities has made it a popular procedure that is widely used.

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Let’s take a look at how ICSI has contributed to ART, focused mainly on male infertility.

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1. Sperm cells with structural abnormalities

With ICSI, it has been made possible to treat fertility factors that are associated with sperm structure, for example a more rounded head shape of the sperm cell or Globozoospermia, or an abnormal flagella that affects sperm motility, also known as primary ciliary dyskinesia among other morphological conditions. With ICSI, it has been made possible for men to father children despite the abnormalities.

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2. Genetic indications 

Conditions such as Klinefelter’s syndrome can cause Azoospermia or severe Oligozoospermia, meaning the sperm count goes extremely low, making it impossible or very difficult to conceive naturally. With ICSI, the required sperm cell can be extracted and injected into the egg cell. 

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3. Infectious agents in semen

In infections such as HIV or Hepatitis C, the sperm cells themselves do not have an HIV receptor, meaning they are not affected by the virus, it infects the seminal plasma. With IUI, it is possible to wash off the sperm and get rid of seminal plasma, however it can also lead to loss of additional sperm cells, making ICSI the ideal option. Till date, all babies born via ICSI have been free of viral infections even when their fathers were.

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4. Ejaculatory dysfunction

In conditions such as retrograde ejaculation, the ejaculation reverts back into the bladder rather than out through the penis causing infertility in men. Also known as dry orgasm, there are very little or no sperm cells coming out of the penis and conceiving naturally is not possible in this case. ICSI can be employed in this case to help the couple conceive.

These are a few of the infertility-causing conditions that can be overcome using IntraCytoplasmic Sperm Injection. Technology is constantly evolving and we are being led to a better world where no one has to suffer the stigma and the suffering that infertility brings. Let’s not hesitate to seek medical attention when we need it and fight infertility with hope and positivity.

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References:

• https://www.cdc.gov/art/key-findings/icsi.html#:~:text=For%20cycles%20without%20male%20factor%20infertility%2C%20ICSI%20use%20was%20associated,births%20compared%20with%20conventional%20IVF.
• Devroey, P., & Van Steirteghem, A. (2004). A review of ten years experience of ICSI. Human Reproduction Update, 10(1), 19-28.
• Collins, J. A. (2002). An international survey of the health economics of IVF and ICSI. Human reproduction update, 8(3), 265-277.
• Haddad, M., Stewart, J., Xie, P. et al. Thoughts on the popularity of ICSI. J Assist Reprod Genet 38, 101–123 (2021). https://doi.org/10.1007/s10815-020-01987-0
• Adamson, G. D., de Mouzon, J., Chambers, G. M., Zegers-Hochschild, F., Mansour, R., Ishihara, O., Banker, M., & Dyer, S. (2018). International Committee for Monitoring Assisted Reproductive Technology: world report on assisted reproductive technology, 2011. Fertility and sterility, 110(6), 1067–1080. https://doi.org/10.1016/j.fertnstert.2018.06.039
• Kim LU, Johnson MR, Barton S, Nelson MR, Sontag G, Smith JR, et al. Evaluation of sperm washing as a potential method of reducing HIV transmission in HIV-discordant couples wishing to have children. AIDS. 1999;13(6):645–51.
• Yakass, M. B., Woodward, B., Otoo, M. A., & Hiadzi, E. K. (2014). Case report: A healthy live birth following icsi with retrograde ejaculated sperm. African journal of reproductive health, 18(4), 123–125.

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