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Intra-cytoplasmic Sperm Injection (ICSI)

Infertility can be a challenging and emotional journey for many couples. With advancements in reproductive technology, various treatments have become available, offering hope to those struggling to conceive.

Among the most innovative treatments in the fertility field is intra-cytoplasmic sperm injection (ICSI), a procedure that can make the dream of parenthood a reality for many couples facing specific fertility obstacles. Couples who have been diagnosed with male factor infertility are excellent candidates for ICSI.

ICSI at ONE Fertility Kitchener Waterloo: What Is ICSI and How Does It Work?

ICSI stands for intra-cytoplasmic sperm injection, a highly specialized form of IVF that is primarily used to tackle significant male fertility issues. During ICSI, a single sperm is injected directly into an egg, enhancing the chances of fertilization when sperm-related abnormalities are present.

  • Comparison to Standard IVF: In standard IVF, eggs are harvested from the ovaries and then placed in a petri dish with thousands of sperm; fertilization occurs when one of the sperm penetrates the egg on its own. In contrast, ICSI involves the direct injection of a selected sperm into the egg, effectively bypassing the natural fertilization barriers that may be hindering conception.
  • Benefits: ICSI offers hope for couples where the male partner has issues with his sperm. This includes low sperm count, poor sperm motility, and abnormal sperm shape (morphology). It’s also beneficial when sperm has trouble attaching to the egg and can be a viable option for men who have undergone a previous vasectomy. ICSI makes fertilization possible when it may not occur via standard IVF.

When Is ICSI Recommended?

ICSI is a commonly used procedure when a male has low sperm count, poor motility, azoospermia (absence of sperm in semen), abnormal morphology, or a blockage in his reproductive tract. It is also used after a failed IVF or when in vitro matured eggs or frozen eggs are used.

Other fertility treatments may also be viable in cases where male factor infertility exists. Some of these treatments include:

  • Intrauterine insemination (IUI) involves a sperm sample being inserted into the uterus during ovulation.
  • Zygote intrafallopian transfer (ZIFT) or tubal embryo transfer involves the eggs fertilized in a laboratory before being transferred into the fallopian tube instead of the uterus.
  • Gamete intrafallopian transfer (GIFT) involves the eggs and sperm being transferred into the fallopian tube for natural fertilization.

Is ICSI Right for You?

Before deciding if ICSI is right for you, schedule a consultation with one of the specialists at ONE Fertility Kitchener Waterloo. During the initial consultation, we will evaluate the reproductive health of both you and your partner to create a baseline. By undergoing a series of diagnostic tests, such as a semen analysis, genetic testing, hormone tests, and ovarian reserve testing, we can create a personalized treatment plan.

When pondering the intricate decision of whether or not to opt for ICSI, it’s important to consider the financial investment. The financial costs for the procedure are high but a portion may be covered under the Ontario Health Insurance Plan (OHIP) and/or the Ontario Fertility Program. It’s also important to consider your and your partner’s age and the emotional toll it can take on you and your partner.

A Step-by-Step Guide to the ICSI Procedure at ONE Fertility Kitchener Waterloo

The ICSI process unfolds across several key stages:

  • Ovarian Stimulation and Monitoring: Similar to IVF, the woman will be given daily hormone injections for 10 to 12 days beforehand to increase the number of mature eggs. The ovary stimulation will be closely monitored with ultrasound imaging until the eggs are ready for retrieval.
  • Egg Retrieval: Once the eggs are mature, the woman will receive an injection to trigger ovulation and release the eggs within 36 hours. The eggs are extracted from the ovaries using a fine needle under ultrasound guidance.
  • Sperm Selection: From the sample of sperm retrieved, a selection of the best candidates is chosen based on motility and morphology. This is a critical step as the success of ICSI hinges on the quality of sperm selected.
  • ICSI Injection: Also known as micromanipulation, a microneedle is used to carefully inject the chosen sperm directly into the cytoplasm of the egg.
  • Fertilization and Embryo Culture: Once the egg and sperm are merged, the fertilized eggs are observed as they grow into embryos over five days.
  • Embryo Transfer: Using a fine catheter, the embryo is transferred to the uterus. It is common practice for one embryo to be used at a time except for women over the age of 40 who may have two transferred to increase the chances of a full-term pregnancy.
A Step-by-Step Guide to the ICSI Procedure at ONE Fertility Kitchener Waterloo

Potential Risks and Considerations

While ICSI is a ground-breaking procedure, it does come with its considerations and risks. Couples should discuss these concerns with their fertility specialist to weigh the benefits of ICSI against the potential risks.

  • Medical Risks: There is less than a 5% chance of damage occurring to the eggs during needle insertion, as well as bleeding or infection during the egg retrieval. There have been rare cases where Ovarian Hyperstimulation Syndrome (OHSS) occurs in women, causing pain and swelling. There is also a small chance of developing a reaction to the fertility medications and procedures involved.
  • Emotional Impact: The entire fertility journey can be emotionally challenging. With ICSI, the emotional stress of worry, anticipation, and disappointment can put a strain on a relationship. The financial investment of treatment can also produce strain.
  • Ethical Concerns: Couples may face ethical decisions regarding leftover embryos and the potential for multiple births if several embryos are implanted.
  • Support Resources: Whether a person is going through fertility treatment alone or with a loving partner, support is an important part of the journey to parenthood. ONE Fertility Kitchener Waterloo provides one-on-one counselling, group support, and other support resources.

ICSI Success Rates and Expectations

Depending on numerous factors, such as the lifestyle of both partners, the quality of the sperm sample, and the underlying cause of the infertility, ICSI has a 50% to 80% fertilization success rate. As with any form of assisted reproductive technology, successful fertilization does not always guarantee a successful live birth. Every infertility treatment is different and some people require multiple ICSI cycles.

Choose ONE Fertility Kitchener Waterloo for Individualized Care

ONE Fertility Kitchener Waterloo offers comprehensive treatment plans for couples trying to navigate their fertility journey. Our experienced and certified specialists provide scientific-based therapies, one-on-one counselling, and state-of-the-art technology to help obtain success stories. Contact us today to book a consultation with one of our esteemed fertility specialists.


4271 King St East, Suite 200
Kitchener, ON
N2P 2X7

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Monday-Friday: 7am-3pm
Saturday-Sunday: 8am-12pm

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Phone: 519.650.0011
Fax: 519.650.0033