ICSI, IMSI & P-ICSI: Procedure & success rates

What is ICSI, IMSI, P-ICSI?

Intracytoplasmic Sperm Injection (ICSI) is another possible IVF treatment that is used when the man's sperm quality is so low that independent fertilisation of the egg cell by the sperm is not possible.

For the ICSI fertilisation the biologists at the TFP fertility clinic select the “fittest” of the partner’s sperm. The seminal filaments are drawn up individually in a thin pipette and directly injected into the egg cell that has been extracted from the woman. Over 90% of the female eggs can be fertilized in this way.

The ISCO fertilisation is carried out under a special microscope, and the biologists and embryologist require a lot of experience and in particular routine during this procedure.

The pretreatment of the patient is similar to that of IVF treatment.

When is ICSI used?

The ICSI treatment is applied in the following cases:

• when the number of sperm is limited (less than 10 million sperm per millilitre)

  
  

• an earlier attempt at fertilisation has been unsuccessful ("null fertilisation")

  
  

• when there are morphological disorders: if the sperm's head doesn't have the correct shape to allow it to penetrate and thus fertilise the egg.

Requirements for ICSI treatment

The only prerequisite for ICSI is the presence of at least some motile sperm in the ejaculate or in the testis or epididymis.

If there is a complete absence of sperm in the ejaculate (azoospermia) or if sperm cannot be released through masturbation, it may be possible to find sperm for ICSI with the help of direct tissue sampling (TESE).

Apart from this, artificial insemination with the ICSI method does not differ from conventional in vitro fertilisation (IVF).

What is the success rate of ICSI?

The pregnancy rate per treatment is comparable to the success rate of the classic IVF method, and that with often very limited quality of the sperm material.

At TFP Fertility clinics, on average, between 40% and 60% of all eggs fertilised by ICSI develop to the blastocyst stage. The pregnancy rate with ICSI is around 50%.

What can I do if pregnancy is not achieved even with ICSI?

If attempts to become pregnant using the ICSI method have failed several times, the so-called morphologically selected sperm injection (IMSI) is another possibility P-ICSI (or PICSI) can also be considered. Here, sperm are selected according to their degree of maturity, which is determined in a hyaluronidase binding test.

What is the IMSI method?

In the IMSI method, our specialist staff work with a powerful microscope. With this microscope, the magnification of the sperm is about 15 times the normal amount. Only optimal sperm are selected.

What is a PICSI (Physiological ICSI) method?

In sperm selection using P-ICSI, we use hyaluronic acid to separate mature sperm from immature sperm. The enzyme hyaluronidase is only produced by mature and genetically perfect sperm. Hyaluronidase is located in the head of the sperm and ensures the dissolution of the outer egg membrane when it meets an egg. This allows the sperm to penetrate the egg so that fertilisation can occur.

Your first consultation at TFP

Do you have specific questions about the ICSI procedure or your chances of pregnancy? Simply call us and arrange a first consultation with our fertility experts at your preferred TFP clinic in Vienna, Wels or Klagenfurt.