Infertility is a complex, subtle, and sometimes unexplained condition. Despite many well-timed attempts, there could be several reasons for a couple’s inability to conceive. In fact, the word ‘infertility’ is used if a couple fails to get pregnant despite unprotected sex for more than a year. The reasons for this can be male infertility, female infertility, or both.
The most common causes of male infertility are low sperm count, abnormal sperm structure or function, low sperm motility, and blockages preventing sperm delivery. You can overcome all these problems by opting for the ICSI procedure. While in vitro fertilisation (IVF) is based on sperm fertilising the mature egg in a petri dish in a lab, the ICSI procedure takes it a step further by fertilising the mature egg by injecting a healthy sperm into it. This method is especially effective if you have sperm motility issues in which the sperm cannot swim, reach, or penetrate the egg naturally.
Sperm motility impairment
Research shows that about 40-50% of infertility cases can be attributed to male infertility. And, 2% of all men have some form of lowered sperm parameters including poor motility. Motility is a critical factor in conception because the sperm has to enter the woman’s reproductive tract and then penetrate the oocyte (mature egg). If sperm motility is low, the sperm may not even reach the egg or be able to penetrate it. The ICSI procedure allows men with motility issues to become a father.
How does the ICSI procedure work?
First things first, ICSI full form is Intracytoplasmic Sperm Injection. It means that the sperm is injected into a mature egg using an injection. The ICSI full form indicates how in this procedure, the sperm is not left to travel to the egg or penetrate the egg on its own. Motility issues in sperm can adversely affect the chance of conception. You can get past this hurdle by opting for the ICSI procedure.
A step-by-step guide to the ICSI procedure clearly shows how and why it is ideally suited for motility-related male infertility issues:
- When you reach out to an infertility specialist, both you and your partner will have to undergo tests to determine your ability to conceive as a couple. The man undergoes a semen analysis at this stage.
- Once motility issues are established in the semen sample, most likely, your doctor will recommend the ICSI procedure over the IVF process.
- If you agree, the doctors will follow a similar protocol as IVF to stimulate the woman’s ovaries and extract mature eggs. During this time, the man will be asked to give a fresh semen sample for the ICSI process. Sometimes, when the male partner is unavailable, your doctor may collect and freeze the semen sample earlier.
- The semen is then washed and cleaned, and the most healthy sperm are collected for further use.
- Then, a single healthy sperm is injected directly into a suitable, mature egg. The embryologist selects a fast-moving, normal-shaped sperm for this. In this way, several selected mature eggs are injected with the sperm.
- Fertilised eggs are then cultured in an incubator in the lab. Those that develop into healthy fertilised eggs or blastocysts are transferred to the woman’s uterus for implantation.
- If the fertilised egg gets implanted successfully, it establishes pregnancy, and you will get a positive result for a pregnancy test in the next two weeks.
- At this stage, extra embryos can be frozen for future IVF cycles.
For the man, the ICSI procedure is not invasive and does not require him to undergo any medical procedure. Except for semen collection, the male partner does not have much role after the initial tests are done to identify if ICSI is the best procedure.
IVF vs. ICSI
ICSI is a form of IVF treatment. Often, couples get confused between the two terms because many more options come under the IVF umbrella. ICSI is a better-suited method for motility issues than other IVF methods because of the following reason—in other IVF methods, the sperm and eggs are placed together in the lab to fertilise without external help. Sperm with poor motility may still be unable to fertilise the egg.
With the ICSI procedure, the sperm is carefully injected right into the egg, reducing the chances of a failed fertilisation. While there is no 100% success guarantee, ICSI improves fertilisation chances in low-motility cases significantly.
When is ICSI ideal?
The ICSI procedure is a good option for achieving pregnancy despite sperm motility issues. It also helps with other fertility problems, such as:
- Egg cannot be penetrated easily
- Sperm cannot leave the male reproductive tract owing to blockage
- Too few sperm for other fertilisation methods
- Fertilising frozen eggs
It is important to remember that ICSI does not have a 100% guaranteed pregnancy rate, but it does address several male infertility issues. The most critical thing here is that the ICSI procedure offers a great chance for males with sperm motility issues to father a biological child.
