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Intracytoplasmic Sperm Injection (ICSI) is an additional component of an IVF cycle usually used because of male factor issues or as a result of poor fertilization on a previous cycle. This procedure consists of taking a single sperm and injecting it into the egg using a very sophisticated microscope and handling equipment. A very fine glass micropipette is used to immobilize the sperm by gently swiping the pipette on the neck of the sperm just below the head to "paralyze" it. The sperm is aspirated into this thin micropipette. A holding pipette stabilizes the egg using gentle suction. The micropipette, with the sperm, penetrates through the "shell" or zona pellucida and the inner membrane or oolemma and deposits the sperm into the cytoplasm of the egg.
After each mature egg is injected with a sperm they are then placed into culture medium inside the incubator until the next day when they are checked for fertilization. The fertilization rates using ICSI at The Center for Reproductive Medicine are 75-85%. Day 3 or Day 5 transfer will then be determined based on the number of good quality embryos on Day 2. ASRM guidelines are followed when deciding the number of embryos to transfer back.

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Assisted Hatching

The embryo is surrounded by a thick outer shell called the zona pellucida which protects the embryo until it reaches the blastocyst stage of development. At this point the blastocyst stage embryo is ready to "hatch" out of the shell and implant into the uterine lining. In certain cases it may be more difficult for the embryo to hatch out of the shell. It can be beneficial in these situations to do assisted hatching which makes a hole or weak spot in the shell or zona pellucida thus allowing the embryo to easily hatch.

We have recently added the Zilos Laser Hatching system to our microscope in our laboratory. This is one more example of us meeting our goal of keeping The Center for Reproductive Medicine on the cutting edge of Assisted Reproductive Technology on the Gulf Coast.

Indications for Assisted Hatching (AH):

• Age - In couples having IVF with the female partner's age >38.
• Elevated FSH - In couples in which the female's Day 3 FSH (Follicle Stimulating Hormone) is elevated.
• Embryo quality - In couples having IVF with poor quality embryos-defined as high percentage of fragmentation or slow rate of cell division on day of transfer. If fragments are present, AH is performed in conjunction with fragment removal.
• Thick Zona Pellucida - In couples doing IVF with thick zona pellucida (outer shell)
• Previous Failed IVF - In couples doing IVF with one or more previous failed IVF cycles.

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