I.
What does it consist of?
ICSI is an intracytoplasmatic injection of spermatozoa into the oocyte.
II. When is it indicated?
• Serious male factor
• Azoospermia (total absence of spermatozoa in ejaculate.
Spermatozoa are
obtained from testicular biopsy or epididymis aspiration)
• Oligozoospermia (low concentration of spermatozoa in ejaculate)
• Asthenozoospermia (pathological increase of spermatozoon
mobility)
• Teratozoospermia (high percent of spermatozoa with anormal
morphology)
• Acrosomic anomalies
• Immunologic reasons. Antisperm antibodies
• "Valuable semens". Patients who are going to
have radio- or chemotherapy
treatment, since although there is enough quantity to make
an IVF or even an
artificial insemination we would only dispose of a quantity
for one or two
cycles. With ICSI the possibilities will increase
• Impossibility of taking the sample for psychological, ethical
or paraplegical
reasons, or nervous section that prevents ejaculate
• Failure in IVF fecundation. Or low fertilisation ratio
or high polyploidy rates
• Failure of artificial insemination. If we microinject at
least half of the oocytes
obtained from patients with three AI failures in the first
cycle of IVF we
guarantee as a minimum transfer of embryos
• GPD (Genetic Preimplantational Diagnosis). This need the
ICSI since with
IVF there might be contamination with spermatozoa which
might drag to
realise the biopsy of the blastomeres whose chromosomes
also might
object to the probe and so mask the results.
III. Procedure
This procedure is almost identical to in vitro fecundation. The only difference
is the handling of the obtained oocytes after the puncture, since they
undergo a more laboured micromanipulation technique than a conventional
IVF.
IV. Results
With conventional IVF, results depend on singular factors, principally
the woman’s age and the causes, which have indicated this procedure
should be used. Generally the ratio of gestation is around 40-45%, rising
to almost 70% in patients under 35 years. |