Should I use Intracytoplasmic Sperm Injection (ICSI)? (ICSI in Taiwan)
1/14/2014 08:30:00 PM
Due to the changes of global climate and general living style, the quality of male sperm, including the morphology and the mobility, has become worse and it also decreased the fertilization rate in the IVF realm. Nowadays, intracytoplasmic sperm injection is the most common technique at ART labs ...
(Source: http://www.goivf.com/treatment-options/ivf-process/male-factor-icsi-tese/ )
Traditional treatments to the fertility problems caused by male factors were limited before 1992. It takes about 74 days to generate mature sperms at testes, so these male patients also needed to take such the same time to receive stimulation injections or oral medications. Thus their patience and perseverance were really the challenges to whom were eager to be fathers. Things were dramatically changed in 1992. Belgium doctor, Dr. Gianpiero Palermo, successfully fertilized the oocytes through Intracytoplasmic Sperm Injection (ICSI) and brought all the IVF patients to another milestone.
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What is Intracytoplasmic Sperm Injection?
ICSI is to inject a single sperm with good shape and mobility into a mature egg (MII oocyte). Though this technique is developed for those with poor quality of sperms, it has become very popular for general IVF cases recently. Then many people may have the question about the appropriate conditions to use ICSI.
A. Unexplained or Idiopathic Infertility
About 20% IVF cases cannot find the reasons for their situations. It could be explained as the problems of sperm-egg attraction/recognition, deficient of sperm penetration, abnormal zona pellucida of oocytes ...etc, and all these issues could affect the fertilization and ongoing development of embryos. Intriguingly, recent reports showed that there were no statistically differences of fertilization rate, implantation rate and clinical pregnancy rate between the cases with using ICSI and those without. However, using ICSI increases the amount of embryos indeed.
B. Oocytes with poor quality
When the technician observed that the quality of retrieved oocytes were poor, including thick zona pellucida, rough cytoplasm or uneven shape, ICSI could be the better choice to increase the fertilization rate and the amount of available embryos.
(Source: http://humrep.oxfordjournals.org/content/24/11/2778/F2.expansion)
C. Advanced maternal age or fewer eggs
According to the previous researches, the thickness of zona pellucida is increased with maternal age. For the females with advanced age or poor remaining amount of eggs, ICSI comparatively ensures the amount of available embryos. However, the fertilization rate, implantation rate and clinical pregnancy rate are not absolutely improved after using ICSI.
D. Repeated IVF failures
The reasons for the failures have not been explained. Therefore, ICSI becomes more promising to the future programs.
E. Oocyte cryopreservation and In Vitro Maturation, IVM
The covered cumulus cells of the oocytes were generally removed before freezing the oocytes, so it may cause the fertilization problems after thawing them. For these frozen-thawed eggs, ICSI would be more available method.
In addition, the zona pellucida of immature oocytes easily get affected after retrieving. Thus ICSI are also the better choice to those IVM eggs.
C. Advanced maternal age or fewer eggs
According to the previous researches, the thickness of zona pellucida is increased with maternal age. For the females with advanced age or poor remaining amount of eggs, ICSI comparatively ensures the amount of available embryos. However, the fertilization rate, implantation rate and clinical pregnancy rate are not absolutely improved after using ICSI.
D. Repeated IVF failures
The reasons for the failures have not been explained. Therefore, ICSI becomes more promising to the future programs.
E. Oocyte cryopreservation and In Vitro Maturation, IVM
The covered cumulus cells of the oocytes were generally removed before freezing the oocytes, so it may cause the fertilization problems after thawing them. For these frozen-thawed eggs, ICSI would be more available method.
In addition, the zona pellucida of immature oocytes easily get affected after retrieving. Thus ICSI are also the better choice to those IVM eggs.
There are some limitations depending on the fertility clinic's policies in terms of age and services covered.
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