chapter  19
8 Pages

Intracytoplasmic Sperm Injection

WithEmad Fakhry, Medhat Amer, Botros Rizk

The main indication is severely impaired sperm parameters, severe oligozoospermia, severe asthenozoospermia, and severe teratozoospermia. Intracytoplasmic sperm injection (ICSI) has enabled clinicians to reach the same fertilization rates reached with in vitro fertilization (IVF) in cases without severe male factor parameters. According to the protocol selected, a gonadotrophin-releasing hormone (GnRH) antagonist or a GnRH agonist is prescribed to allow complete control over ovulation once the treatment cycle begins. In order of severity, complications of ICSI include ovarian hyperstimulation syndrome (OHSS), ectopic pregnancy, multiple gestations pregnancy, perinatal complications, drug side effects, and complications of the operative procedure. Safety studies regarding IVF/ICSI outcome versus IVF alone in the perinatal period and the medical and psychological development of those children have been carried out repeatedly since the early years of ICSI. ICSI is the first choice for azoospermic males, either obstructive or nonobstructive, who need surgical-sperm retrieval. ICSI has better fertilization rates in cases with high sperm antibody titers.