The ICSI procedure can enable fertilisation to take place despite issues such as low motility that could prevent natural conception or normal in vitro fertilisation. The ICSI procedure is particularly valuable if you have had a vasectomy or if there are issues with sperm production or ejaculation, as even small amounts of sperm can be collected and injected directly into the egg.
Producing a Sperm Sample
If you are undergoing IVF using the ICSI procedure, you will be asked to provide a fresh sample of sperm on the same day that your partner’s eggs are collected, if possible. However, if you are unable to do so, there are several collection techniques that can be used to obtain a sperm sample. It is also possible to perform the ICSI procedure with a frozen sample of sperm if one is available. For example, you may have had some of your sperm frozen before having a vasectomy.
Collecting a Sperm Sample
If you aren’t able to produce a sperm sample in the normal manner, if the sperm can’t make its way out of your testicles, or if your sperm count is very low, a sample can be collected directly for use in the ICSI procedure. Sperm can be taken either from your testicles or from the epididymis, the narrow tube in which the sperm cells are stored as they mature. These procedures are known as testicular sperm aspiration (TESA) and percutaneous epididymal sperm aspiration (PESA), and they involve the insertion of a very fine needle to remove the sample. If it isn’t possible to collect enough sperm using the TESA or PESA procedures, another option is available. It requires the removal of a small piece of your testicular tissue, from which the sperm will then be isolated in vitro. This procedure is known as testicular sperm extraction or TESE. Once the sample has been obtained, individual sperm cells will be injected into each egg using the ICSI procedure. The chances of success will then be the same as for the normal IVF procedure.