Dr. J. Michael Putman, M.D.
Best Doctors: Infertility 2008,2009,2010,2011,2012, 2013
What is ICSI?
ICSI stands for intracytoplasmic sperm injection. Simply, this means injecting a sperm into the egg to help a sperm fertilize the egg and develop to an embryo. It was first developed for humans in 1988, and the first pregnancies occurred in 1992.
What is the process of ICSI, and how is it performed?
ICSI is a highly specialized part of the in-vitro fertilization (IVF) process for couples who are unable to have a pregnancy by any other method. The process involves using an inverted microscope that has special micromanipulation tools mounted on it. The embryologist uses one glass tool to hold the egg in position while selecting the sperm to be placed into the egg by stopping its movement and gently suctioning it into a fine glass needle. The embryologist must use robotic hand controls for the process. Once the selection is made, the needle with sperm is passed through the outer shell (zona pellucida) of the egg into its cytoplasm (the non-nucleus part of the cell). The sperm is placed into the center of the egg, which is checked the following day to determine if fertilization is successful.
Who needs ICSI? Is the procedure just for male factor couples?
Initially, ICSI was used only for couples with severe male factor where the sperm numbers or quality were so poor that the egg couldn’t be fertilized by putting sperm and egg together in a petri dish in an incubator (standard IVF). In these cases, the sperm were not able to penetrate the outer shell of the egg. By passing through the outer shell, the sperm could then be placed into the main part of the egg (cytoplasm), and fertilization could occur. This made it possible for men to have a genetically-related child instead of having to use another man’s sperm (donor sperm). While it was first developed for male factor, ICSI has other indications for use in IVF. As women age, the outer shell of the egg can thicken or harden making sperm penetration more difficult. ICSI is often recommended for women who are 38 or older. In situations where women who have low egg numbers because of age, surgery on the ovaries, or unusual or unknown factors, ICSI can ensure a sperm has been placed inside each egg.
“You will know the day after ICSI was performed if the egg was fertilized successfully.”
Can ICSI affect a baby’s development?
If a woman gets pregnant naturally, there is a three percent chance the baby will have a major birth defect. The chance of birth defects after ICSI is rare. Certain conditions that have been associated with the use of ICSI (Beckwith-Wiedemann syndrome, Angelman syndrome, hypospadias, or sex chromosome abnormalities) are thought to occur in far less than one percent of children conceived using this technique. Some of the problems that caused your infertility may be genetic. Therefore, boys conceived with the use of ICSI may have infertility issues as adults if their father had severe male factor.
How soon will I know if it ICSI is effective?
You will know the day after ICSI was performed if the egg was fertilized successfully. In general, the embryologist will keep you up-to-date on the growth and development of your embryos. Depending on your specific situation, embryos may be implanted (placed with a small catheter) into your uterus three or five days after egg retrieval. A pregnancy test will be scheduled to determine if the IVF/ICSI procedure was successful.
Dr. Michael Putman is an innovator in treatments for reproductive disorders. In Dallas, he pioneered the use of microsurgical techniques for procedures such as tubal ligation reversal and reproductive laser surgery. Using minimally invasive procedures, advanced laparoscopy and hysteroscopy, he is able to treat complex endometriosis, uterine fibroids, congenital abnormalities, and tubal disease. Dr. Putman earned his M.D. at the Medical College of Georgia. He came to Dallas and trained in Obstetrics and Gynecology at Baylor University Medical Center. Named a D Magazine Best Doctor in Dallas numerous times, Dr. Putman pioneered the application of microsurgical techniques for reproductive procedures such as tubal ligation reversal, reproductive laser surgery, and advanced techniques in laparoscopic and hysteroscopic surgery. Dr. Putman holds four international patents for inventing new robotic surgical instruments and is actively developing new instrumentation for improving pregnancy rates with in-vitro fertilization.
Fertility Center of Dallas
Baylor Medical Pavilion
3900 Junius Street #610
Dallas, Texas 75246