Intracytoplasmic Sperm Injection (ICSI) Treatment in South Africa


Intracytoplasmic Sperm Injection (ICSI) treatment has revolutionised male infertility treatment. With approximately 30% to 40% of all infertility due to the male factor, it has been regarded as one of the major breakthroughs in the treatment of infertility.

Since only a few normal sperm are needed for conception using ICSI, even men who were previously seen as completely sterile now have an excellent chance to have their own child and an alternative to donor sperm. Since it was developed in Belgium in 1992, ICSI treatment has been used worldwide and has proven extremely successful in achieving fertilisation, resulting in tens of thousands of babies being born.


What is ICSI treatment?

ICSI treatment is a procedure in which the sperm are directly injected into the egg. It is used as part of In Vitro Fertilisation (IVF) treatment for those who have severe male infertility.

Where does ICSI fit into IVF treatment?

In the simplest terms, IVF treatment is a process in which the egg and sperm are fertilised outside of the body to form an embryo, which is then transferred to the uterus to hopefully implant and become a pregnancy.

However, IVF treatment is not a single process, but a series of procedures that are completed over five stages to complete a treatment cycle. The whole process from commencement of ovarian stimulation up to the embryo transfer stage usually takes around three weeks.

Standard IVF treatment begins with hormone therapy to stimulate the development of several follicles in the ovary. Using ultrasound technology, the follicles are punctured with a specialised needle to retrieve the eggs. The eggs are then placed with the sperm in a petri dish (‘in vitro’ which literally means ‘in glass’) for fertilisation to create several embryos. The embryos are then nurtured in an incubator for 5 days, where after one or two embryos are transferred through the vagina to the uterus where implantation will hopefully occur and result in pregnancy.

The five basic stages involved in the IVF procedure are summarised below.

The Five Basic Stages in the IVF Procedure

Stage 1: Ovarian Stimulation and Monitoring
Stage 2: Egg Retrieval
Stage 3: Fertilisation and Embryo Development
Stage 4: Embryo Transfer
Stage 5: Luteal Phase Support

ICSI treatment is used in Stage 3: Fertilisation and Embryo Development, instead of natural fertilisation which is used in standard IVF treatment.

For a more detailed explanation of each of the IVF treatment stages, click here

What does ICSI treatment involve?

The first stages of ICSI treatment are the same as for conventional IVF. During Stage 1 – Ovarian Stimulation and Monitoring – the female partner takes fertility drugs to stimulate her ovaries to produce several eggs that can be collected in Stage 2 – Egg Retrieval. Both are precisely the same in ICSI treatment as it is for IVF treatment.

How ICSI treatment differs from IVF treatment is in the way the egg is fertilised during Stage 3. In standard IVF treatment, the sperm is allowed to penetrate the egg of its own accord.

Between 50,000 and 100,000 sperm are placed in the same dish as a single egg to naturally fertilise the egg during standard IVF treatment. Normal fertilisation is often confirmed the next morning if no abnormalities exist in the sperm.

However, in cases of male factor infertility with significant abnormalities in the count, motility, and/or shape of the sperm, standard IVF may result in very poor fertilisation rates, often resulting in no fertilised eggs and thus no embryos for transfer.

In an ICSI cycle, however, qualified technicians – using very fine tools in a process known as micromanipulation – inject each suitable mature egg with a single prepared sperm cell.

First, a semen sample is prepared at Medfem Fertility Clinic’s advanced onsite lab to collect as many healthy moving sperm as possible. The sperm are washed and prepared for fertilisation. Then, using a high magnification microscope, a single sperm in injected into the centre of a mature egg using a very fine glass needle many times thinner than a human hair.

This maximises the chance of fertilisation taking place as several steps in the early fertilisation process are bypassed and any potential problems the sperm may have in getting inside the egg is circumvented.

Below you can watch a video of the ICSI treatment process being performed at Medfem Fertility Clinic – one of the pioneers of IVF and ICSI treatments in South Africa:

The injected eggs are then nurtured in an incubator and checked the next day for signs of fertilisation. The embryos most likely to grow into a healthy baby are then selected for transfer and inserted into the uterus in the same way as for standard IVF.

Who is ICSI treatment for?

ICSI treatment is used primarily when the male partner has poor semen characteristics and offers an alternative to donor sperm for those who have severe male infertility. This includes the following male fertility challenges:

* Low sperm count
* Poor sperm morphology – referring to abnormally shaped sperm
* Poor sperm motility – referring to slow moving sperm
* An obstruction preventing sperm release – a vasectomy or a blockage caused by disease, injury or a genetic condition that prevents sperm reaching the ejaculate
* Antisperm antibodies – produced by the man’s body, these antibodies may inhibit sperm function
* Vasectomy reversals resulting in very low sperm counts or poor-quality sperm production.

ICSI treatment is also offered to couples who have had poor or no fertilisation during standard IVF, or when fertilisation is thought to be less likely to occur with routine IVF.

While ICSI treatment does not absolutely guarantee fertilisation, the rate of complete failed fertilisation is very low.

To date, tens of thousands of children have been born around the world as the result of ICSI.

How successful is ICSI treatment?

Since ICSI treatment was introduced almost 3 decades ago, it has proven extremely successful in achieving fertilisation, revolutionising male infertility treatment. As ICSI involves the injection of only a single selected sperm into each egg, even the most severe of male factor abnormalities can be overcome.

ICSI treatment has a rate of fertilisation around 70%. While ICSI does not absolutely guarantee fertilisation, the rate of complete failed fertilisation is very low and is most common in cases with limited egg supply.

Since only a few normal sperm are needed for conception using ICSI, even men who were previously seen as completely sterile now have an excellent chance to have their own child and an alternative to donor sperm. As such, ICSI treatment is regarded as one of the major breakthroughs in treatment of male infertility and has resulted in tens of thousands of babies being born around the world.

ICSI treatment in South Africa

ICSI treatment is available in South Africa at advanced fertility clinics such Medfem Fertility Clinic, where ICSI, IVF and other fertility treatments are provided by a team of highly-qualified and experienced fertility experts and embryologists; and trained, qualified theatre staff, nurse practitioners, clinical psychologists and specialist pharmacists in state-of-the-art facilities equipped with advanced technologies to maintain a leading pregnancy success rate.

What does ICSI treatment in South Africa cost?

At Medfem Fertility Clinic, the cost of IVF/ICSI treatment is around R91,672.00, while the cost of Low Dose ICSI Treatment is around R73,418.00. (Prices valid until December 2019. For updated prices, please click here… )

However, it is important to realise that the costs of IVF and IVF/ICSI treatment can vary quite significantly from one couple to another, for a number of reasons. The first is that there are many variables that affect the treatment plan and associated costs for each patient, including the cause of the couple’s infertility and specific medications required. Secondly, it is important to realise that receiving in vitro fertilisation treatment is not a single process, but rather a series of procedures. In addition, more than one treatment cycle may be required.

For this reason, it is important to confirm all costs before proceeding with any treatments and to understand what is included in standard charges and what separate or additional fees apply.

At Medfem Fertility Clinic, your fertility specialist will provide a written quote for a clear treatment plan to ensure you have a full view of the cost implications.

The first step in ICSI treatment

Starting IVF/ICSI treatment can be a very exciting time, taking you another step closer to becoming parents.

The first step to receiving ICSI treatment is as simple as contacting us. To book an initial consultation, click here or contact us telephonically on +27 (11) 463 2244.

We look forward to meeting you!

At the first consultation, you will meet one of our four IVF/ICSI specialists to discuss your medical history, conduct a comprehensive infertility work up, explore the options, and start to plan your journey to parenthood.

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