For many couples, the journey to parenthood can be challenging. A common misconception is that infertility is primarily a female issue. However, the reality is that male factor infertility is a significant and prevalent cause, affecting nearly half of all couples who struggle to conceive.
Sperm has one primary biological purpose: to travel to and fertilize an egg. Various factors can prevent this from happening naturally. These can range from a low number of sperm to issues with their movement or shape. Fortunately, reproductive technology has made remarkable advancements.
Intracytoplasmic sperm injection (ICSI) is a revolutionary technology designed specifically to overcome these male fertility challenges. This article aims to demystify these challenges and explain precisely how ICSI for male factor infertility could be the solution many are seeking.
The Puzzle Pieces: Common Causes of Male Factor Infertility
Several issues can hinder sperm from completing their journey to the egg. Understanding these specific problems is an individual’s first step toward finding a solution.
Low Sperm Count (Oligospermia)
This condition, defined as having too few sperm in the ejaculate (i.e. low sperm count), significantly reduces the chances of natural conception. Even if the sperm present are healthy, their sheer lack of numbers makes the odds of one finding and fertilizing an egg extremely low.
Poor Sperm Motility (Asthenozoospermia)
Motility refers to the sperm’s ability to move effectively. Asthenozoospermia is a condition where sperm are present but cannot swim properly. You can think of them as being stuck in traffic; they have a destination but are unable to make progress. Without the ability to travel through the female reproductive tract, they cannot reach the egg.
Abnormal Sperm Shape (Teratozoospermia)
The shape, or morphology, of a sperm is crucial for its function. Sperm with an abnormal head, mid-piece, or tail are less likely to fertilize an egg. These shape abnormalities can prevent the sperm from penetrating the egg’s protective outer layer, making natural fertilization impossible.
Other Factors
There are less common issues that can also contribute to male factor infertility. These include blockages that prevent sperm from being ejaculated (obstructive azoospermia) or problems with sperm production itself (non-obstructive azoospermia), where there is an absence of sperm in the semen.
Assembling the Solution: How ICSI Solves Each Puzzle
So, how does ICSI work?
ICSI is a highly specialized form of in vitro fertilization (IVF). Unlike traditional IVF where thousands of sperm are placed in a dish with an egg, with the hope that one will fertilize it, ICSI involves the direct injection of a single, carefully selected sperm into the cytoplasm of a single egg. This bypasses many of the natural barriers to fertilization.
Solving Low Sperm Count
Because ICSI requires only one viable sperm per egg, a low sperm count becomes largely irrelevant. An embryologist can select the healthiest available sperm from the sample, even if the total number is very small, and use it for fertilization.
Overcoming Poor Motility
ICSI completely removes the need for sperm to swim. Since the embryologist manually selects a sperm and injects it directly into the egg, its ability to move on its own is no longer a factor. This directly overcomes the challenge of asthenozoospermia.
Addressing Abnormal Morphology
A skilled embryologist uses a high-powered microscope to examine the sperm sample. They can identify and select the best-shaped, most viable-looking sperm for the injection. This selection process maximizes the chance of successful fertilization and a healthy embryo, even if a large portion of the sperm sample has an abnormal shape. The ICSI success rates for male factor infertility are between 50% and 80% for fertilization.
Handling Blockages
For men with obstructive azoospermia, sperm cannot be ejaculated. ICSI is crucial in these cases.
Doctors can retrieve sperm directly from the testicles using testicular sperm extraction (TESE) or testicular sperm aspiration (TESA), or from the epididymis, using percutaneous epididymal sperm aspiration (PESA) or microsurgical epididymal sperm aspiration (MESA). This retrieved sperm can then be used in the ICSI procedure to fertilize an egg.
The ICSI Process: A Step-by-Step Overview
Understanding how ICSI for male factor infertility works can help demystify the process and set clear expectations. The procedure involves several coordinated steps.
Step 1: Egg Retrieval
The process begins with the female partner undergoing ovarian stimulation to produce multiple mature eggs. These eggs are then carefully retrieved from the ovaries under ultrasound guidance.
Step 2: Sperm Preparation
A sperm sample is collected, either through ejaculation or surgical retrieval. The sample is then processed in the lab, where the embryologist washes and prepares it to isolate the healthiest, most motile sperm.
Step 3: The Injection
This is the core of the ICSI procedure. Using a tiny, hollow needle, the embryologist carefully picks up a single selected sperm. Under a powerful microscope, the needle is used to inject the sperm directly into the center (cytoplasm) of a mature egg.
Step 4: Embryo Development
After the injection, the fertilized egg, now called an embryo, is placed in a special incubator. It is monitored closely for several days to ensure it is growing and developing properly.
Step 5: Embryo Transfer
Once an embryo reaches the appropriate stage of development (typically 3–5 days after retrieval), it is transferred into the woman’s uterus using a thin catheter. Any additional healthy embryos can be cryopreserved for future use.
Hope Through Technology
Male factor infertility is a common challenge, but with today’s advanced reproductive technologies, it is not an insurmountable one. ICSI offers a precise and highly effective solution for a wide range of sperm-related issues, providing hope and a clear path forward for many couples. By directly addressing the specific barriers to fertilization, ICSI has revolutionized fertility treatment in Kitchener, in Canada, and around the world.
If you are facing challenges with male factor infertility, you are not alone. To learn more about our male infertility treatments and how ICSI for male factor infertility could help you on your journey to parenthood, we encourage you to book a consultation with ONE Fertility Kitchener Waterloo today.
