ICSI & poor sperm morphology...

[willtherebe4]

Hi Carole,

Can you please advise exactly what you look for when doing ICSI? Does ICSI overcome the barriers of low quantity / motility or morphology obtained by a semen analysis?

Does poor morphology also correlate to poor quality and likely to lead to a non viable embryo if it does fertilise?

TIA.

[Carole]

Hi Carole,

Can you please advise exactly what you look for when doing ICSI? Does ICSI overcome the barriers of low quantity / motility or morphology obtained by a semen analysis?

Does poor morphology also correlate to poor quality and likely to lead to a non viable embryo if it does fertilise?

TIA.

For ICSI, the technician will look for sperm with normal morphology and sign of life. If the sample is a normal sample, there are many swimming, normal looking sperm to choose from. In samples in which there are few sperm, and/or poor moving- even immotile (non-moving) sperm- this simple objective becomes more difficult. Sometimes its a matter of choosing the best from the worst.

Although there is a correlation between low quality in the sense of poor DNA quality, and sperm appearance, it is not absolute. We have gotten full term pregnancies from poor quality sperm, but it is less frequent.

Regarding ICSI to overcome low quantity- In the sense that you only need one sperm per egg, if the tech has as many sperm as there are eggs, in theory that's all you need- assuming the sperm are all alive and normal enough to fit into a pipette.

Regarding ICSI to overcome low motility- sperm only have to be motile enough (a twitch will do) to show that they are alive. The technician breaks the membrane behind the head--before injection-- which stops the movement. You don't want to inject a moving sperm into an egg. Even non-moving sperm can be identified as alive using special tests like hypoosmotic swelling (HOS) test , but it's best to be able to choose a moving sperm.

Here is more on the topic--with other links to more info-- from my blog: Fertility Lab Insider - Lessons learned from over fifteen years of working inside fertility labs. » Blog Archive » Wishing for a Happy Father’s Day: Male Infertility Treatment

Good Luck!