To ICSI or not to ICSI

Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technology (ART) used to treat sperm-related infertility problems. ICSI is used to enhance the fertilization phase of in vitro fertilization (IVF) by injecting a single sperm into a mature egg.
Under high-power magnification, a glass tool (holding pipet) is used to hold an egg in place. A microscopic glass tube containing sperm (injection pipet) is used to penetrate and deposit one sperm into the egg. After culturing in the laboratory overnight, eggs are checked for evidence of fertilization. After incubation, the eggs that have been successfully fertilized (zygotes) or have had 3 to 5 days to further develop (zygotes or blastocysts) are selected. Two to four are placed in the uterus using a thin flexible tube (catheter) that is inserted through the cervix. The remaining embryos may be frozen (cryopreserved) for future attempts.

Intracytoplasmic sperm injection (ICSI) is used to treat severe male infertility, as when little or no sperm are ejaculated in the semen. Immature sperm collected from the testicles are usually unable to move about and are more likely to fertilize an egg through ICSI. It is also helpful when the sperm is poorly shaped, it allows the embroyologist to pick the best sperm to fertilize the egg with.

Some couples choose to try ICSI after repeat in vitro fertilization has been unsuccessful. In the United States, about half of IVF procedures are currently performed using ICSI technology. Myself I find this absolutely crazy, why would couples not want to ICSI, why would you want to take the risk of eggs not fertalizing? I just do not get that!!

ICSI is also used for couples who are planning to have genetic testing of the embryo to check for certain genetic disorders. ICSI uses only one sperm for each egg, so there is no chance the genetic test can be contaminated by other sperm.

There has been some studies that show that using ICSI gives you a slightly higher change of having identical twins, but there is not enough evidence to support that quite yet.

So, we will be doing ICSI, we have to, with John's sperm which is poorly shaped and the potential that my eggs are too hard, that would make natural fertilization more difficult. So whatever the risks, I feel the benefits outweigh the risks.