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ICSI, intracytoplasmic sperm injection, is a relatively recent development in the fertility world. It is used in combination with IVF, and was first introduced in 1992. With ICSI, one sperm is directly injected into one egg in a lab setting, in order to fertilize it. This has offered a solution to couples for whom male infertility is an issue. Does ICSI carry any risks?

Who is a candidate for ICSI?

ICSI is suitable for men who have a very low sperm count (oligospermia), or whose ejaculate contains a large number of sub-standard quality sperm, like sperm that does not move very well or has an abnormal shape or in medical terms, a man whose sperm has motility and morphology problems. ICSI can also help men who have a vasectomy or other sperm delivery problem. In this case, sperm needs to be extracted directly from the testicle before it will be injected into the egg.

ICSI risks

Because ICSI is still a relatively new fertility treatment, the long-term risks are not very well understood yet. Research conducted to date shows that babies conceived with ICSI have normal motor and cognitive skills, but there are some other risks:

  • Boys born as a result of ICSI have the potential to inherit their father's infertility, according to medical speculation. Because the oldest boys born after ICSI are still in their teens, there is no reliable information about this possibility yet.
  • A small percentage (4.2 percent according to one major study) of children born after ICSI have genetic and developmental defects. This is three times higher for the specific defects than it is for babies who were conceived naturally.
  • You may have a slightly higher chance of having a miscarriage after undergoing IVF with ICSI, because it is possible that the sperm had chromosomal abnormalities not compatible with the embryo developing fully.
  • A low sperm count can be caused by underlying genetic conditions, among which cystic fibrosis. If this is true in your specific case, the condition could be passed on. You may therefore wish to undergo genetic screening before opting to undergo ICSI treatment.

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