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Development and implementation of intracytoplasmic sperm injection (ICSI)
G D Palermo1, J Cohen, M Alikani
1Centre for Reproductive Medicine and Infertility, New York Hospital-Cornell Medical Centre, NY 10021, USA.
Reproduction, Fertility, and Development
|January 1, 1995
Summary
Intracytoplasmic sperm injection (ICSI) offers a successful micromanipulation for male infertility, achieving high fertilization and ongoing pregnancy rates in couples with previous IVF failure or severe male factor issues.
Area of Science:
- Reproductive Medicine
- Assisted Reproductive Technology
- Embryology
Background:
- Intracytoplasmic sperm injection (ICSI) is a key micromanipulation technique in assisted reproduction.
- Male infertility significantly impacts conception, often necessitating advanced reproductive technologies.
- Previous in vitro fertilization (IVF) attempts frequently fail due to severe male factor infertility.
Purpose of the Study:
- To detail the experimental development and human application of intracytoplasmic sperm injection (ICSI).
- To evaluate the efficacy of ICSI in treating male infertility and previous IVF failures.
- To report pregnancy and delivery outcomes following ICSI procedures.
Main Methods:
- ICSI procedure involving the injection of a single spermatozoon directly into a mature oocyte (metaphase II).
- Analysis of 355 ICSI cycles, including data from couples with prior IVF failures or extremely poor semen parameters.
- Oocyte retrieval, injection survival rates, zygote formation, and ultrasound-confirmed pregnancies were monitored.
Main Results:
- A high oocyte survival rate (93.6%) and bipronuclear zygote yield (64.5%) were achieved.
- An ongoing pregnancy rate of 38.6% per retrieval and 40.5% per embryo replacement was observed.
- 22 deliveries occurred, with ongoing pregnancies including singletons, twins, triplets, and one quadruplet.
Conclusions:
- ICSI is a highly successful micromanipulation procedure for treating male infertility.
- The technique effectively addresses cases of failed IVF and severe oligoasthenoteratozoospermia.
- Spermatozoa concentration minimally influenced fertilization and pregnancy outcomes in ICSI cycles.