- October 19, 2017 at 18:40 #3955
Intracytoplasmic sperm injection (ICSI) can be used in cases of male factor infertility or perhaps in cases when a previous standard IVF led to <30% of eggs fertilized. It was then realized that all you need is only one viable sperm to fertilize the egg. ICSI involves the injection of a single sperm directly into the oocyte. In Ukraine, ICSI is used in almost all IVF cycles. Fertilization rates after this procedure are within 60%-70% (comparable to the rates achieved with a standard insemination when the semen parameters are normal). Males with severe oligospermia (count <5 million sperm/cc) should have a karyotype performed since they are at greater risk for having a chromosomal abnormality. Couples should be counseled that there is an increased risk of sex chromosomal anomalies in infants born after the ICSI procedure when it is performed in cases of severe oligospermia. The rate of sex chromosomal aneuploidy in infants conceived naturally is 0.2% and is 0.8% after the ICSI procedure. These chromosomal abnormalities are likely not the result of the ICSI procedure itself but are attributed to the low level of mosaicism present in the spermatogonia. Couples may opt for a prenatal genetic testing during the pregnancy to detect potential chromosomal problems. Many cases of male factor infertility are caused by microdeletions on the Y chromosome. Couples should be counseled that this genetic testing is available, and if a defect is found, then it could be transmitted to a male offspring.
The morning after insemination, the eggs are examined to determine whether fertilization has achieved. The two pronuclei (one from the sperm and the other from the egg) should be present within the egg. Within a few hours, the nuclei unite and the embryo will start to divide.
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