Intracytoplasmic
Sperm Injection

In any field of medical research, success is often measured in small degrees, resulting in only those who work in laboratories to see the impact. Occasionally, a discovery comes along that is so outstanding it revolutionizes medical treatments. Such is the case with Intracytoplasmic Sperm Injection (ICSI). A Belgian physician pioneered the ICSI process in 1991 and first reported his incredible successes at the annual American Fertility Society (now known as the American Society for Reproductive Medicine) scientific conference. When a single sperm was injected directly into an egg, it virtually eliminated the limitations found with previous male factor fertility treatments, not only addressing the issues of poor sperm motility and low count, but also showing success with sperm considered less than ideal for conventional IVF procedures. Today, ICSI has been successfully used to treat men with fresh sperm collected directly from the testis and epididymis, as well as those whose sperm was previously cryopreserved.

There are many physical steps involved in the process of conceiving a child, and a variety of problems can prevent the sperm from making its journey to fertilize the egg. Sometimes the man does not produce enough sperm, the sperm can’t swim properly, or the sperm can’t penetrate the egg. Other factors that could affect a man’s fertility include infection, hormone imbalances, injury, varicoceles, and psychological stress.

In most cases, sperm can be retrieved from the male reproductive tract and used for fertilization.

In most cases, sperm can be retrieved from the male reproductive tract and used for fertilization.

Testicular epididymal sperm extraction (TESE) and aspiration (TESA) are procedures performed by an urologist during which minute pieces of tissue are removed from the anesthetized testes. Once the tissue sample arrives at the laboratory, the tissue is minced and observed under the microscope. If sperm are present, they can be used to fertilize eggs through Intracytoplasmic Sperm Injection (ICSI) to produce embryos. These procedures bring hope to men with vasectomies, failed vasectomy reversals, congenital absence of the vas deferens, obstruction of the epididymis, and other conditions.