ICSI Sperm prep is a sperm preparation technique used IVF cases where the sperm numbers are very low.
During an evaluation of a couple for infertility problems, the physician usually asks the husband to go to Ovation Fertility Austin for a semen analysis. This diagnostic test is used to find the sperm count, the percent of motile (moving) sperm and the percent of sperm that have normal morphology (shape). It is common to find one or more of these elements of the semen analysis to be abnormal. In fact, 40 % of the couples who undergo in vitro fertilization (IVF) in this country have male factor infertility as the single cause of their problem, while another 20% have it as one of multiple causes.
When the semen analysis is performed at Ovation Fertility Austin, a single drop of the sample is placed on a sperm-counting slide. This slide is examined in order to assess how many sperm are present in the volume of semen ejaculated. Occasionally, when the slide is examined, no sperm are seen. When this happens, the embryologist needs to find if the semen sample contains a very low number of sperm that were not picked up in that drop which was placed on the slide, or if there are actually no sperm present in the sample.
The next step is to add an enzyme and a small volume of medium to the semen sample. The semen sample is then centrifuged in order to concentrate all of the sperm that are present into a very small volume. Once this is done, a drop of the concentrate is placed on a sperm-counting slide to see if any sperm can be seen. If there are no sperm apparent in this concentrated volume, the next step is to perform an ICSI prep. ICSI stands for a procedure called intra-cytoplasmic sperm injection. This is a sperm preparation technique used in some IVF cases including those in which the sperm numbers are very low. The details of the procedure are located in this web site.
In order to perform an ICSI prep for sperm during a semen analysis, the concentrated sample is then placed into a drop in a Petri dish and covered with oil in order to prevent evaporation. The drop is then scanned for the presence of any sperm. This slow, deliberate scan of the entire sample will take several minutes and will allow the lab staff to determine if there are any sperm present and if there are enough sperm to use for an IVF case.
Another problem which may be seen during a routine semen analysis is the apparent lack of motility, or movement, of the sperm. When this is observed, a technique is used that is also used during IVF cases in which the sperm has a very low percent of motility, or even no motility at all. This technique involves the washing and concentration of sperm just as mentioned above in an ICSI prep. The sperm are resuspended in a small volume and then placed into a drop of pentoxifylline under oil. This chemical is harmless to sperm and it acts as a stimulant to them. So, sperm that are alive, but non-motile, are agitated by the presence of this chemical and are observed swimming. If they respond to the presence of pentoxifylline, the sperm are alive and can be used for injection during an IVF case.
The final report is written and it is sent to the patient’s physician. The results of these tests are very significant in the planning of the future treatment of this couple. If there are sperm present and they are alive, the couple will have an option to undergo an IVF cycle with the use of ICSI in order to accomplish fertilization. If sperm are not seen even after an ICSI prep or show no signs of life, the couple will have to discuss other options such as surgical retrieval of sperm or the use of donor sperm.