ICSI has revolutionised the treatment of male infertility, offering assistance to couples who previously were unable to have a baby whose father was the genetic parent.
With ICSI, very few sperm are required and the ability of the sperm to penetrate the egg is no longer important as this penetration is bypassed by the injection technique. This has changed the course of the treatment of male infertility, helping up to 95% of couples to reach embryo transfer who previously had only donor sperm or adoption to choose from. It is important to remember that whilst ICSI is a technique used in the laboratory to help fertilisation occur, it does not guarantee it. From the couple's perspective this technique is the same as IVF treatment, the only difference being the laboratory process used to fertilise the egg.
Our Centre was one of the first NHS units in the UK to be licensed to offer this treatment and has since carried out several thousand ICSI cycles with consistently good fertilisation and pregnancy rates. For couples requiring ICSI the treatment pathway is identical to that of IVF, except for the method of insemination. For ICSI, the sperm is injected directly into the prepared egg, rather than simply mixed with the eggs in a dish.
Specialist equipment is used to enable our embryologists to manipulate the eggs and sperm under the control of high-powered microscopes, performing very precise surgical procedures on a microscopically small scale. Tiny glass instruments are used in the laboratory which hold the eggs in place (micropipettes) and enable sperm to be injected through the outer layers of the egg (micro-needles), past the shell of the egg (zona pellucida) and into the main body of the egg (cytoplasm).
The couples go through the same preparatory processes as IVF, namely ovulation induction and egg collection. The difference is how the embryologist deals with the eggs and sperm in the laboratory.
ICSI is used in the following circumstances:
Only eggs from large follicles that are sufficiently mature can be injected by ICSI. It must be noted that the process of injecting the sperm into the egg can result in damage to the egg which means that approximately 90% of the eggs injected survive. ICSI does not guarantee fertilisation but, on average, we expect that 60-70% of injected eggs will fertilise. ICSI is at least as successful as standard IVF.
ICSI cannot be performed if there are no sperm being produced by the testes which is, however, rare.
According to the HFEA regulations, if no fertilisation occurs following routine IVF insemination, those eggs cannot then undergo ICSI in the same cycle.
Because intra-cytoplasmic sperm injection (ICSI) is a fairly new treatment (it was introduced in 1992), it is not yet known whether there is any risk that injecting the sperm into the egg could damage it, with possible long-term consequences for the child.
According to HFEA the risks that have so far been associated with ICSI are:
There is a link with the gene mutation which causes cystic fibrosis and very severe male infertility. We recommend that all patients with an extremely low sperm count are tested to determine whether or not they carry this mutation.
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IMPORTANT INFORMATION ON BLOOD TESTING DUE TO COVID-19
If you are experiencing symptoms associated with COVID-19, e.g. fever, loss of taste or continuous new cough, please DO NOT attend for a blood test.
Earlier this year, the Government revised the guidance on Shielding for CEV patients. All those who have been identified as CEV have been advised to follow the same guidance as everyone else, whilst potentially thinking about extra precautions you could take to reduce your chance of catching COVID-19.
Taking into account this guidance, and the evidence that most patients have now resumed having their blood tests at their usual preferred location, UHCW will no longer be providing the Shielding phlebotomy service from Monday 13 December 2021. You will need to make arrangements to get your blood tests done, as you did prior to the pandemic at locations across Coventry and Warwickshire at www.uhcw.nhs.uk/bloodtests If your specialist has requested a blood test which is due to be taken prior to Monday 13th December, you can expect it to take place at a ‘Pop-up’ clinic, as before. Any blood tests required after this date will need to be a booked appointment.
You can keep up to date with the latest advice from the Government and from UHCW on the following website: www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
Click on the map for information about phlebotomy clinics in Coventry. You can book an appointment online at the locations in red.
Please book an appointment before attending for a blood test. Click on the ‘Book Online’ button above. Booking an appointment helps patients, their carers and family members to plan their hospital visit better, helping to reduce clinic waiting times and enabling patients to be seen much more quickly.
Location: Outpatients Department, on the ground floor. Opening hours: 8am-4.45pm, Monday to Friday (excluding bank holidays).
Children under 16 years old will need to book online here.
Please book an appointment before attending for a blood test, click on the ‘Book Online’ button above. Patients from Rugby and the surrounding areas are able to access the Friends Blood Taking Unit at the Hospital of St Cross.
Referrals for blood tests can be from GP's, practice nurses or from hospital consultants. Patients are also able to leave other samples, such as urine, which have been collected at home, at the hospital's Pathology Reception.
Location: Near Brookfield House, just off North Road - map here. Opening hours: The blood taking clinic sessions for adults and children are listed below:
Monday -Friday 7am-4:45pm Appointment only
Wednesday Evening 5pm-7pm Suspended due to COVID
Saturday Morning 7am-10pm Suspended due to COVID
April 2020 NEW - This Clinic is now by appointment. Please book an appointment before attending for a blood test. Click on the ‘Book Online’ button above.
Address: Stoney Stanton Road, Coventry CV1 4FS Location: Access is via the main doors, the Phlebotomy team are in Area A. Opening hours: Monday to Friday (excluding bank holidays). 8am–4.45pm
Glucose Tolerance Test (GTT)
Specialist Tests - There are a small number of specialist tests where blood needs to be taken on a hospital site as the sample must be transferred to the laboratory rapidly for the test to be undertaken. Click here for a list of these specialist tests and to find out more.