In the past, intracytoplasmic sperm injection (ICSI) , an in vitro-fertilization method, has been used predominantly in cases of moderate or severe male factor infertility. More recently many IVF centers have applied ICSI as a preferred method of fertilization in non-male infertility cases, as well. It is well recognized that when ICSI is performed for male infertility there is a definite increase in embryo defects and related miscarriages.
A few years ago, a large study in Sweden (2003) followed by one reported from Egypt (2004) clearly showed that when ICSI is performed for non male factor infertility, IVF outcome is not prejudiced, and the rate of pregnancy loss and birth defects are unaffected.
Since the Danish study does not differentiate between cases where ICSI was done for male factor versus non male factor infertility, it is likely that their finding of an increase in still births might be due to the effect of abnormal sperm on the embryo’s health rather than being due to the ICSI process itself. And… since male factor infertility requires ICSI, there is no avoiding this procedure in such cases anyway.
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3 comments:
hello dr sher,
my husbands SA was as follows:
volume 3.0
rapid 61 %
slow 3%
immotile 32%
abnormal 97%
motility 235
count 115.5
liquefaction yes
agglutination 0
We were going to do ivf next month for tubal factor, then we found out his morphology is only 3%. However the RE I was going to use says his facility does not do icsi based on morphology alone and that our chances of success are fine without icsi. do you agree? i really want a second opinion on this... Thank you!
Do you agree with not doing icsi if one's morphology were the only problem with one's semen analysis? if one had 3% morphology but the count and motility were fine, should one do icsi?
I personally believe in doing ICSI, especially if the Kruger sperm morphology is <4%
Geoff Sher
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