ICSI Procedure Overcomes Infertility in Men
ICSI Treatment Cost • ICSI Success Rates • Male Infertility
IVF or ICSI • About ICSI • ICSI Risks • ICSI Assisted Hatching
IVF ICSI (acronym for Intracytoplasmic Sperm Injection & pronounced "ICK-SEE") has been the most popular infertility treatment and more widely used than "conventional" IVF since the year 2000.
In the past 11 years, ICSI has increased from 54% of cycles performed to more than 61% in North America, from 46% to 54% in Europe, up to more than 76% in Latin America and over 92% in the Middle East.
In Thailand (and most other advanced countries of the world), ICSI has been used more often than IVF since 2007.
And every year IVF is used less by reproductive doctors trying to get the highest rate of success helping patients trying to conceive a baby.
It is similar to the way ICSI IVF treatment have almost completely replaced former infertility treatments such as gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT).
ICSI price? ICSI treatment cost is Baht 170,000 or the approximate equivalent of US$5,667 | €3985 | INR 298,901 | AUD$5,554 | SGD$7,074 | HKD$45,576 at the infertility center of Disavowed Hospital in Bangkok, Thailand.
IVF ICSI cost is only Baht 20,000 more than IVF alone — ICSI is excellent value for money.
That means at Disavowed Hospital in Thailand, ICSI costs approximately US$678 | €480 | INR 35,165 | AUD$653 | SGD$832 | HKD$5,362 in addition to the cost of standard IVF. See our article about Disavowed Hospital for cost of IVF and all other possible IVF costs.
What is ICSI?
ICSI is used when sperm is weak or few or some other factors are inhibiting fertilization. ICSI is basically a “wheelchair for infirm sperm combined with a door-to-door delivery service”.
An embryologist laboratory technician selects a single ICSI sperm from the sample obtained from the husband on Day 14 of the IVF ICSI process and injects it directly into each egg in the laboratory using a powerful microscope and fine glass needle. The ICSI sperm's only job is to fertilize the egg and start the embryo. A few days after fertilization using ICSI, the best embryos are transferred to the mother's uterus.
In 40-50% of infertile couples, the problem is male infertility and then ICSI can be very helpful.
ICSI is often used if sperm analysis & OATs Assessment shows the husband has:
- very low sperm count well below 20 to 150 million per ml (Oligospermia);
- low sperm motility manifested by bad swimmers or less than 49% moving at all (Asthenospermia);
- poor quality sperm with abnormals over 41% (Teratospermia);
- low progression with a vigor rating of 1 out of 3;
- sperm sticking together and clumping because of antibodies in semen; and/or
- abnormal rate of liquefaction;
ICSI enables the best sperm to be chosen and used. That is particularly important when one, or both, of the parents-to-be are older than 35.
When men over 35 are the father in any IVF procedure, the number of miscarriages goes up and the number pregnancies goes down because sperm quality and quantity decrease and DNA damage increases with their age — a “strong paternal age-related effect” on ability to create a test tube baby according to Dr. Stéphanie Belloc of Eylau Centre for Assisted Reproduction in Paris.
The outer membrane (zona pellucida) of the mother's egg effectively prevents DNA-damaged sperm from getting through. That means no fertilization if only IVF is used and the sperm gets no assistance.
ICSI gives the embryologist the power to choose the “best man for the job”. It gets the ICSI sperm past the very selective zona pellucida. That results in a fertilization rate of at least 60% and sometimes up to 85% for those few precious eggs and sperm. In other words, you get the greatest possible number of embryos. That gives you the best possible chances of having the baby you want and the gender you prefer.
ICSI sperm does not have to be a strong swimmer. ICSI sperm does not have to compete. ICSI sperm does not have to survive attack. It does not have to do anything but fertilize. No need for brute force. ICSI means almost zero collateral damage.
ICSI means high efficiency. ICSI is highly effective. ICSI is economic use of your funds and reproductive resources. And it only costs about US$671 more than mere IVF.
ICSI provides greaters embryo safety and survivial in addition to more efficient use of your reproductive resources. If two sperm ever manage to penetrate any egg it will self-destruct.
ICSI eliminates this possible loss of a test tube baby and possible destruction of any of an infertile couple's few & precious eggs, sperm & embryos.
If eggs are limited, as is usually the case with infertile couples, the mother-to-be has none to spare, unlike healthy women who have more eggs than they could possibly use in one lifetime. And the father has no sperm to spare.
Instead of millions of healthy sperm aggressively trying to be the winner and fertilize the egg, there may be only a few, and they may NOT be in top shape.
The problem can be so serious that the sperm must be acquired by surgical extraction using TESE, MESA, PESA, not ejaculation.
Although ineffective with men with zero sperm, Testicular Epididymal Sperm Extraction (TESE), Microsurgical Epididymal Sperm Aspiration (MESA), Microsurgical Epididymal Sperm Extraction (MESE), Percutaneous Epididymal Sperm Aspiration (PESA), Microsurgical Testicular Sperm Extraction (MicroTESE), Testicular Fine Needle Aspiration (TFNA) in conjunction with ICSI have greatly improved male infertility treatment by IVF doctors. It is one of the primary reasons for the ever improving IVF success rates of fertility centers.
In our article comparing Thailand IVF success vs the IVF success rates of leaders in infertility treatment worldwide, you will note that it is now a common feature in all annual reports on infertility treatments to show IVF vs ICSI statistics.
IVF or ICSI?
In both ICSI and IVF, eggs and sperm (gametes) are collected from each parent.
In IVF, the eggs and sperm are mixed together in a dish and fertilization must be accomplished without assistance — a single natural step in an unnatural process.
Although not actually laser-guided, ICSI precisely delivers a single sperm to the egg. No waste and only fertilization is left to nature.
Normally, IVF or ICSI are used only for infertile couples.
ICSI is more efficient and better than IVF for both fertility and infertility.
ICSI Success Rates | IVF ICSI Risks
ICSI results in a fertilization rate of 60%-85%. It is still being debated by the medical community whether ICSI results in more live births. As is often the case in health care, reports come to different conclusions.
But the current consensus is that ICSI does improve infertility treatment success when the primary obstacle to getting pregnant is caused by infertility in men.
In Canada, which is the most successful country in the world in overcoming infertility, ICSI results in 44.6% clinical pregnancies and a live-birth rate of 36.1%. That is quite good.
There is zero evidence that ICSI has any negative impact on ICSI babies and the success rates of live births in any infertility centers.
ICSI risks? The longest running ICSI programme in the USA, led by Professor Gianpiero Palermo MD of Cornell University who pioneered ICSI treatment in 1992, reports they have found “no differences in the ability of an embryo generated by IVF or ICSI to implant, even after undergoing the stress of cryopreservation.”
Why did Dr Palermo develop the ICSI procedure and what is the purpose of his ICSI treatment? To help couples: “have a healthy baby using the safest and most effective treatment possible.”
In other words, the embryologist's ICSI “sperm in a wheelchair door-to-door delivery service” has no negative consequences compared to the slightly more natural method of leaving the step of fertilization to the eggs and sperm.
The longest running single-clinic ICSI program in Europe (19 years in Belgium), has determined that women under 38 benefit most from ICSI and when the ovarian stimulation results in 11 or more eggs being retrieved from a single cycle.
Gynaecologist Dr Dominic Stoop of the Center for Reproductive Medicine in Brussels also discovered that the main factor contributing to a higher live birth rate was the ovarian response to stimulation and that ICSI resulted in ectopic pregnancy no more often than it already occurs in the general population with no fertility problems.
ICSI makes sense. The investment of an additional US$671 in ICSI cost makes sense. ICSI improves the odds in your favor.