For some couples dealing with male infertility, in vitro fertilization (IVF) is the treatment of choice. Cleveland Clinic has one of the leading IVF programs in the country with excellent success rates. During the IVF process, the ovaries are stimulated with injectable fertility medications to cause multiple eggs to mature. When the eggs are ready, they are collected in a minor procedure.
Fertilization is accomplished by exposing the eggs to sperm in a culture dish, or by directly injecting a single sperm into each mature egg, a process called intracytoplasmic sperm injection (ICSI). After fertilization, embryo development is monitored over the next three to five days, and two to three embryos then are placed into the uterus by way of a small catheter inserted through the cervix.
Intracytoplasmic Sperm Injection
Artificial techniques of reproduction have advanced to the point where a single sperm can be physically injected into an egg. This procedure, called intracytoplasmic sperm injection (ICSI) has dramatically changed the treatment available for even the most severe male factor infertility. Because of this technique, 90% of all infertile men have the potential to conceive their own genetic child.
In intracytoplasmic sperm injection (ICSI), a single sperm is injected into an egg in a special culture medium. This illustration shows the development of an embryo following fertilization of the egg using ICSI.
Sperm Extraction for In Vitro Fertilization
Approximately 1% of all infertile men are born with the congenital absence of the vas deferens, the “biologic equivalent" of a vasectomy. Unfortunately, there are no artificial tubes that can replace the vas deferens. However, we now are able to help such men conceive using a non-surgical procedure to retrieve sperm from the tiny ducts of the epididymis, freeze them and use them later for in-vitro fertilization (IVF) with the injection of the single sperm directly into an egg.
"Non-obstructive” azoospermia is a condition in which the man does not have sperm in his ejaculation. In about 50% of men with this condition, sperm can be found in the testicles using a microscope. Advances in technology now make it possible to extract those sperm and use them in ICSI.