Intracytoplasmic sperm injection involves obtaining a sample of sperm either by ejaculation or by sucking it out using a needle directed into the testis or epididymis (ouch! yes some local anaesthetic is administered first). The latter procedure is done when there are obstructive problems in the tubes bringing the sperm from the testes to the penis, although the sperm themselves are normal enough to fertilise an egg successfully. It is also done in cases of retrograde ejaculation, where sperm ‘backfire’, entering the bladder instead of passing into the urethra.
Once the sperm are obtained, they are injected directly into the egg (which obviously also needs to be harvested from the woman) in the lab. This is the ICSI part of the procedure. Then the fertilised egg will be implanted in the woman’s uterus. This is also a critically timed event, coordinated with the woman’s cycle to ensure fertilisation and subsequent implantation in the uterus. Most centres performing these sophisticated procedures report pregnancy rates of about 30 per cent. In the case of those couples for whom they don’t work, artificial insemination using donated sperm from a sperm bank is a possibility. You will need careful counselling and lots of discussion with your partner before deciding on this, since the child con ceived will biologically have another father. Adoption and fostering are alternatives that may also be considered.
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Jack and Rena had a combination problem — very low sperm counts on Jack’s part and an irregular cycle on Rena’s. After much thought, they decided to try ICSI and IVF. It worked and they conceived immediately. However, at eight weeks Rena had a miscarriage and the young couple were truly devastated. They didn’t think they could ever go through this again, but after six months they decided to give it one more go…they now have a daughter who they named Prosperity, joking that she was such an investment.
On the other hand, April and Fergus, who had similar problems, looked at the cost of it all and decided to go with adoption, thinking that it would be more of a sure thing.
As you’ve undoubtedly realised by now, the investigation of infertility involves a medical history and physical exam, an analysis of the semen, and then any specialised blood tests, X-rays or ultrasounds that the doctor thinks may help elucidate the cause of your problem, before any remedies are embarked upon. Any illnesses that are present (e.g. thyroid problems, diabetes) need to be treated and hormonal problems appropriately addressed. Although all of this is good for your health, it does not come with any castiron guarantee Viagra online of a baby at the end of it. In around 30 per cent of infertility cases, no obvious cause can be found in either partner and it is this ‘unexplained’ group which has the lowest success rates from IVF and other technologies.
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