Intra Cytoplasmic Sperm Injection (ICSI)

This procedure has revolutionized the treatment of male infertility since it allows couples to achieve fertilization, even when the male partner has only a few viable sperm available. Up to 40% of cases of infertility are due to problems with the quality and quantity of the males sperm.

ICSI fertilization is achieved by highly skilled embryologists in a state-of-the-art embryology lab. During a normal IVF procedure fertilization occurs simply by incubating eggs and sperm together.

With ICSI, the embryologist surgically inserts one healthy sperm into each egg. This is done by delicately perforating the membrane of the egg with a glass pipette containing the sperm. This requires extremely high level skills and experience. As only one sperm is needed per egg, even very small quantities of semen are sufficient.

ICSI is especially important for men with Azoospermia (the complete lack of semen on ejaculation). In such cases, our Doctor also offers procedures such as PESA and TESE. In a high percentage of cases, Azoospermic males can still achieve fatherhood.

Percutaneous Sperm Aspiration (PESA)

PESA is usually the first treatment option the Doctor suggests if the male partner has no sperm in his semen. It is relatively painless and requires no surgical intervention and has high retrieval rates – between 80% and 90%. A fine needle is inserted through the scrotum into the epididymis from which fluid is gently removed by aspirating it through the needle. The fluid is then analyzed for sperm content and motility. PESA usually takes about 10 to 20 minutes and requires only local anesthetic.

Testicular Sperm Extraction (TESE)

If no sperm is found in the epididymal fluid, a needle is gently inserted into the testes. This needle removes a small sample of tissue, which is then examined for sperm in the laboratory. A variant of this procedure involves a small surgical incision in the testis, called a testicular biopsy.

The Doctor has been performing ICSI since 1997 and after hundreds of cycles have achieved success rates comparable to the best in the world.

He generally recommends ICSI for all patients where there may be some doubt as to the viability of their sperm.

ICSI is indicated for Men with sperm problems such as:

  • low sperm count
  • poor sperm motility
  • high percentage of abnormal sperm
  • men with sperm anti-bodies.
  • retrograde ejaculation (ejaculation of the sperm into the urinary bladder)
  • where IVF has been previously unsuccessful.


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