ICSI Manchester

We currently use ICSI in couples with reduced semen counts or where there is reduced sperm motility, in which the risk of fertilisation failure is increased, and also those who have previously had very low or no fertilisation in an IVF cycle.

-Sperm concentration less than 15 X 106/ml
-Progressive sperm motility (categories a+b) less than 32%
-Normal sperm morphology less than 2%
-Reduced fertilIsation rate after conventional IVF: <40% normal fertilisation with at least 4 mature eggs collected
-Failed fertilisation after conventional IVF
-Use of Epididymal/Testicular sperm
-Use of frozen stored sperm (this is not mandatory but we do recommend it in certain situations)
-Patients who have had ICSI in previous IVF cycles should continue to do so in future cycles

Between 3-5% of men with very low sperm counts are more likely to have a rearrangement of their chromosomes responsible for sex determination in babies – known as a balanced translocation. A rearrangement can lead to a chromosome abnormality in any baby conceived. Some men with low sperm counts will have a small deletion of a portion of their Y chromosome i.e. a tiny genetic fragment may be missing. This will not be found in routine chromosome testing. This deletion may be passed on to a baby boy and may cause him to have a lowered sperm count when he grows up.

What happens if your chromosome test shows a rearrangement?

If an abnormality is found, the chance of a pregnancy is less and may increase the chance of miscarriage. The child may be unaffected, but if an abnormality is found in your chromosomes, this your Consultant will discuss everything with you and you would be referred to the Regional Genetics service for further counselling.

Birth Defects

The evidence on whether or not babies born after IVF or ICSI treatment have a greater risk of birth defects is not yet completely clear, and more studies are needed in order to gain further insight into these possible effects. In 2005, a major European review of children born after ICSI and IVF (followed up until age 5) found that major birth defects involving the heart, lungs, musculoskeletal or gastrointestinal systems, were present in about 2% of naturally conceived offspring, 4% of children conceived by routine IVF, and in 6% of children conceived after ICSI. A substantial proportion of the abnormalities in the ICSI children were problems in the development of the urinary or genital organs, especially in boys. However, all of them were correctable by surgery and they reflected paternal genetic factors rather than the procedure itself. Minor birth defects were present in about 20% of naturally conceived offspring, 31% of children conceived by routine IVF, and in 29% of children conceived after ICSI. Minor anomalies are those which do not have serious medical, functional or cosmetic consequences for the child. More recent studies reported no difference in the risk for any anomaly or specific anomalies after different types of IVF technologies including ICSI.

Developmental Delay

Some research papers on follow ups of small numbers of ICSI children suggest possible developmental delay in some children conceived using the ICSI technique. This has not been found in ongoing follow up studies in the UK and Europe.

As with all of our services, if you have any questions or concerns you would like to discuss further, you will have the opportunity to do so at any clinic appointment.