Micromanipulation (ICSI)

By isolating and injecting a single, healthy sperm cell directly into each egg, infertility specialists have made it possible to overcome some of the most severe cases of male factor infertility. Intracytoplasmic sperm injection, or ICSI, allows our Sacramento and Northern California patients with very low sperm counts or high numbers of abnormal or non-motile sperm to successfully impregnate their partner.

The ICSI process begins in the same way as standard in vitro fertilization — with ovulation induction and an egg retrieval procedure. Once the eggs have been removed from the ovaries, the sperm sample is also collected and both are prepared for fertilization.

ICSI departs, however, from standard in vitro fertilization in that our specialists use powerful microscopes and precise equipment to select individual, healthy sperm cells and place them directly into the egg, instead of merely combining the prepared eggs and sperm in a laboratory container and waiting for fertilization to take place on its own. This maximizes the number of successfully fertilized eggs, regardless of the general quality of the sperm.

Embryos created through ICSI will develop the same way as those created naturally or through in vitro fertilization. Success rates for ICSI are comparable to those associated with standard in vitro fertilization (IVF).

Couples who have a known genetic condition that could threaten the life or health of their child may want to consider preimplantation genetic diagnosis, or PGD. This micromanipulation technique makes it possible to detect certain genetic conditions in early embryos prior to transferring them into the uterus. By selecting the embryos that are least likely to carry the genetic material for a disease or condition, we minimize the chances of our patients passing a given condition on to their children. You can learn more about this procedure and how it is performed by visiting our preimplantation genetic diagnosis page.

During the first five to six days after conception, the embryo is encased in a shell-like structure known as the zona pellucida. In order for implantation, and therefore pregnancy, to occur, the embryo must escape from the zona pellucida. This process is known as hatching. In some cases however, the embryo may be unable to hatch, thus preventing implantation and pregnancy from taking place.

For women who have had several unsuccessful cycles of IVF, assisted hatching may offer a solution. Using a special laser, we are able to create a tiny opening in the zona pellucida of an embryo shortly before placing it into the uterus, making it easier for the embryo to complete the hatching process. There is some evidence that women who produce thicker zona pellucida or are in their later reproductive years can benefit from this technique.