ICSI

We can create embryos by combining a single sperm and egg in our lab.

DR. SMITH: ICSI is a procedure by which we pick up individual sperm and inject them into the eggs one-by-one. We do that when the motility of the sperm is sluggish or slow, or the shape of the sperm head is abnormal and we have to hunt down and find normally shaped sperm. In many centers, this ICSI procedure is routine in the sense that they apply it to all patients. I don’t share that philosophy. I think that is procedure is appropriate when there is a problem with the sperm, but should not be generally applied to everyone. The rationale in other programs for using ICSI as a technique for fertilization on all patients is that maybe there is a low number of eggs, or the egg quality is not so good. Simply put, you can’t make a bad egg good by putting a sperm inside it. You may achieve a slightly higher fertilization rate initially. But we have learned because we culture all the embryos to the Blastocyst stage here that you don’t really get any farther ahead. Because those embryos that initially fertilize that are not so good that wouldn’t have fertilized ordinarily, they stop growing in a couple or three days. And so in the end of the percentage of embryos that make it to the Blastocyst stage is about the same in both cases.