In Vitro Insemination

In Vitro Fertilization Program

The oocytes will be inseminated using either conventional in vitro insemination techniques or intracytoplasmic sperm injection (ICSI).  Conventional or “routine” in vitro insemination involves co-incubation of the eggs and sperm overnight.   During this time, approximately 65% of the mature eggs will fertilize when the male partner has normal sperm counts and normal fertilizing capacity.

Intracytoplasmic sperm injection (ICSI) is used to assist fertilization for couples with male-factor infertility that is unresponsive to other clinical and laboratory forms of treatment.  The procedure involves injecting a single, live sperm directly into a mature oocyte.  We recommend ICSI for couples who have no or very low rates of fertilization during previous treatment cycles or when the number of normal motile sperm available is less than that required for standard IVF procedures.  The American Society for Reproductive Medicine recognized ICSI as a standard clinical technique for assisting fertilization in 1994.

Both the fertilization rate, which is the number of eggs that fertilize divided by the number of eggs injected, and the clinical pregnancy rate per egg retrieval, which is the presence of a gestational sac observed by ultrasound, vary with the egg quality, the age of the woman from which the eggs are retrieved and the method of sperm retrieval.  If we determine that ICSI is required for your treatment cycle we will provide you with a more detailed information summary and current statistics after your initial consultation.

It has been our experience, and the experience of programs around the world, that oocytes fertilized after insemination by ICSI with sperm from an ejaculate or from an epididymal aspirate are equal in quality and viability and are capable of implanting in the uterus with the same frequency as oocytes fertilized after conventional in vitro insemination techniques.  Furthermore, the pregnancy, miscarriage and delivery rates following transfer of oocytes fertilized after insemination by ICSI are similar to the outcomes following transfer of fertilized oocytes inseminated by conventional in vitro insemination techniques.  We also have found that oocytes fertilized after insemination by ICSI survive cryopreservation just as well as fertilized oocytes that had been inseminated by conventional in vitro insemination techniques. 

Donor Sperm

If donor sperm is recommended you will need to meet with an IVF Program Counselor to discuss use of donor sperm.  Once the IVF Physicians and Program Counselor determine that use of donor sperm is appropriate, we will provide you with names and contact information for sperm banks that we recommend.  We will only accept sperm from sperm banks that are accredited by the American Association of Tissue Banks.  Patients are responsible for selecting a donor, paying for the sperm and transport costs and assuring that the sperm arrives before the initiation of gonadotropins injections.  Our laboratory requests that you order “unwashed” cryopreserved semen.  The laboratory will isolate motile sperm and wash away the cryoprotectant the day of the in vitro fertilization procedure.