Fertility Clinic Treatments – Intracytoplasmic Sperm Injection (ICSI)

First developed in Belgium in 1992, this treatment reproductive therapy has gained worldwide acceptance and has successfully contributed to the birth of tens of thousands of babies globally.
 

Defining ICSI Treatment

ICSI treatment represents a specialised procedure during which sperm cells are injected directly into eggs.

Specifically designed for couples dealing with severe male infertility challenges, this technique forms an integral component of In Vitro Fertilisation treatment, better known as IVF treatment.
 

ICSI’s Role Within IVF Treatment

To understand where ICSI fits, it helps to first understand IVF treatment itself.

In basic terms, IVF involves fertilising eggs and sperm outside the body to create embryos, which are subsequently transferred into the uterus with the goal of achieving implantation and pregnancy.

IVF treatment encompasses multiple procedures organised into five distinct stages, creating a complete treatment cycle. From the initial ovarian stimulation through to embryo transfer, the entire process typically requires approximately three weeks to complete.

The five core stages of IVF treatment

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

Standard IVF treatment commences with hormone therapy designed to stimulate multiple follicle development within the ovary.

Through ultrasound guidance, the mature follicles are accessed using a specialised needle to retrieve the eggs.

Following retrieval, eggs are combined with sperm in a petri dish (the term ‘in vitro’ translates literally to ‘in glass’) in the lab to facilitate fertilisation and embryo creation.

The embryos undergo nurturing in an incubator over 3 to 5 days, after which one or two embryos are selected for transfer through the vagina into the uterus, where implantation and pregnancy hopefully follow.

ICSI treatment comes into play during Stage 3: Fertilisation and Embryo Development, replacing the natural fertilisation approach utilised in standard IVF treatment.
 

The ICSI Treatment Process

ICSI treatment begins identically to conventional IVF.

In Stage 1 – Ovarian Stimulation and Monitoring – the female partner receives fertility medications to stimulate her ovaries to develop multiple eggs for collection during Stage 2 – Egg Retrieval. These initial stages mirror exactly what occurs in standard IVF treatment.

The distinction between ICSI and IVF treatment emerges in the fertilisation method used during Stage 3.

Standard IVF treatment allows sperm to penetrate eggs naturally and independently. This is done by placing between 50,000 and 100,000 sperm cells alongside a single egg in the same dish to achieve natural fertilisation. When no sperm abnormalities are present, successful fertilisation is typically confirmed the following morning.

However, when male factor infertility involves significant abnormalities in sperm count, motility, and/or morphology, standard IVF may produce very poor fertilisation rates. This often results in zero fertilised eggs and consequently no embryos available for transfer.

During an ICSI cycle, qualified technicians employ very fine instruments through a process called micromanipulation to inject each mature, suitable egg with a single, carefully chosen and prepared sperm cell.

Initially, a semen sample undergoes preparation at Medfem Fertility Clinic’s advanced onsite laboratory to collect the maximum number of healthy, moving sperm possible. The sperm undergo washing and preparation for fertilisation. Subsequently, using high magnification microscopy, a single sperm is injected into each mature egg’s centre using an extremely fine glass needle, many times thinner than a human hair.

This approach maximises fertilisation probability by bypassing several early fertilisation steps and circumventing any potential difficulties the sperm might encounter when attempting to enter the egg naturally.

The fertilised eggs are nurtured in an incubator and examined the next day for fertilisation indicators. Embryos demonstrating the highest potential to develop into healthy babies are selected for transfer and placed into the uterus using the same procedure as standard IVF.
 

Ideal Candidates For ICSI Treatment

ICSI treatment primarily addresses situations where the male partner presents poor semen characteristics, offering an alternative to donor sperm for couples experiencing severe male infertility. This encompasses the following male fertility challenges:

• Low sperm count
• Poor sperm morphology, characterised by abnormally shaped sperm
• Poor sperm motility, characterised by slow-moving sperm
• Obstructions preventing sperm release, including vasectomy or blockages caused by disease, injury, or genetic conditions that prevent sperm from reaching the ejaculate
• Antisperm antibodies produced by the man’s immune system, may inhibit sperm function
• Vasectomy reversals that result in very low sperm counts or poor-quality sperm production.

ICSI treatment also benefits couples who experienced poor or no fertilisation during standard IVF, or in situations where fertilisation seems unlikely to occur with routine IVF.

Though ICSI treatment cannot absolutely guarantee fertilisation, the rate of complete failed fertilisation remains very low.

To date, tens of thousands of children worldwide have been born as a result of ICSI treatment.
 

ICSI Treatment Success Rates

Since its introduction nearly three decades ago, ICSI treatment has demonstrated exceptional success in achieving fertilisation, revolutionising treatment approaches for male infertility.

Because ICSI involves injecting only a single selected sperm into each egg, even the most severe male factor abnormalities can be overcome.

ICSI treatment achieves fertilisation rates of approximately 70%. Though ICSI cannot absolutely guarantee fertilisation, complete failed fertilisation remains very low and occurs most commonly in cases with limited egg supply.

Because only a few normal sperm are required for conception using ICSI, men previously considered completely sterile now have excellent prospects to father their own biological children, providing an alternative to using donor sperm.

Consequently, ICSI treatment is recognised as one of the major breakthroughs in male infertility treatment and has resulted in tens of thousands of babies being born worldwide.
 

ICSI Treatment In South Africa

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

ICSI Treatment Costs In South Africa

IVF and IVF/ICSI treatment costs can vary quite significantly between couples for several reasons.

First, numerous variables affect each patient’s treatment plan and associated costs, including the underlying cause of the couple’s infertility and specific medications required.

Second, it’s crucial to recognise that IVF treatment is not a single process but rather a series of procedures. Additionally, more than one treatment cycle may be necessary.

Therefore, it’s important to confirm all costs before proceeding with treatments and to understand what standard charges include and which separate or additional fees apply.

At Medfem Fertility Clinic, your fertility specialist provides a written quote for a clear treatment plan, ensuring you have complete visibility of cost implications.
 

Beginning Your ICSI Treatment Journey

Medfem Fertility Clinic’s team are a committed and understanding team of medical professionals, who have the experience, knowledge and desire to provide you with the best chance of a successful outcome at the end of your treatment.

Since the 1980’s, Medfem Fertility Clinic’s team has assisted couples struggling with infertility to experience the joy of parenthood, helping to bring more than 18,000 babies into the world.

If you would like to meet one of our fertility specialists, simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.

Our Fertility Specialists can also meet with You During a Virtual Consultation Via Zoom or Skype. Click here to book a virtual consultation now.

We look forward to meeting you!