常见问题:胞浆内单精子注射
- 什么是ICSI?
- 谁应该考虑ICSI?
- 谁应该考虑拆分ICSI?
- ICSI有多成功?
- ICSI有哪些风险?
- 我们所有的卵子都要注射吗?
- Are there differences in embryo quality or pregnancy rates between ICSI and non-ICSI embryos?
什么是ICSI?
胞浆内单精子注射, or ICSI, 将一个活精子直接注射到人类卵子的中心. The technique was developed to help achieve fertilization for couples with severe 男性因素不育 or couples who have had failure to fertilize in a previous in vitro fertilization (IVF) attempt. The procedure overcomes many of the barriers to fertilization and allows couples with little hope of achieving successful pregnancy to obtain fertilized embryos.
The procedure requires that the female partner undergo ovarian stimulation with fertility medications so that several mature eggs develop. 然后用阴道超声将这些卵子从阴道中吸出, 并在胚胎学实验室的精确十大赌博靠谱网络平台下进行培养. The semen sample is prepared by centrifuging, or spinning the sperm cells through a special medium. 这将活精子从碎片和大部分死精子中分离出来. The embryologist then picks up the single live sperm in a glass needle and injects it directly into the egg.
ICSI于1994年在加州大学旧金山分校首次应用, and our first successful birth achieved with ICSI assistance was in February of 1995. UCSF was the first San Francisco Bay Area program to achieve a pregnancy and birth with this procedure.
谁应该考虑ICSI?
ICSI is considered absolutely necessary is in the case of 男性因素不育 with an abnormal semen analysis. 然而,在旧金山湾区,大约75%的试管婴儿病例现在都是ICSI. Patients are electing to undergo ICSI for reasons other than 男性因素不育, including:
- 以前IVF受精不良
- 可变精子数
- 原因不明的不孕
Many patients choose to undergo the ICSI procedure in order to maximize their success even when the procedure is not clearly indicated.
如果你被告知精子检测结果有异常, 你应该认真考虑ICSI. 如果男性伴侣做了输精管结扎手术, we also recommend ICSI regardless of the sperm quality because of the presence of sperm antibodies that may affect fertilization.
The decision to proceed with ICSI is particularly difficult if there is no prior evidence of 男性因素不育. Some couples choose ICSI because they want to do everything possible to maximize fertilization. However, it is important to understand that for many couples with normal sperm parameters, maximal fertilization can be achieved with standard insemination during IVF without the use of ICSI.
谁应该考虑拆分ICSI?
For couples interested in knowing about their own fertilization capability, we offer split ICSI. This option involves performing ICSI on a majority of all mature eggs and incubating the remainder with sperm. 实际上, split ICSI can provide a safety net against failed fertilization with standard insemination.
拆分ICSI的收费与ICSI相同. 分裂ICSI的一个要求是成熟卵子的最小数量. We must be able to identify at least eight mature eggs on the day of your egg retrieval in order to proceed with split ICSI. 如果不满足这个要求,我们将把你所有的成熟卵子都注射进去.
ICSI有多成功?
通过ICSI程序, many couples with difficult 男性因素不育 problems have achieved pregnancy at UCSF. Fertilization rates of 70 to 80 percent of all eggs injected – equivalent to fertilization with normal sperm – are currently being achieved, and pregnancy rates are comparable to those seen with IVF in couples with no 男性因素不育.
The most important indicator of ICSI success appears to be the fertilization rate achieved with the ICSI procedure. The fertilization rate in the UCSF IVF laboratory is exceptional – currently 80 to 85 percent. That is to say, on average, eight out of every 10 eggs will fertilize normally.
ICSI有哪些风险?
有几个风险. First, 在ICSI过程中, a small number of eggs – usually less than 5 percent – can be damaged as a result of the needle insertion. Second, the overall risk of having a baby with a chromosomal abnormality in the X or Y chromosomes is 0.8%,即每1000人中有8人,是平均水平的4倍 自发的概念. 目前,我们还不知道这种风险增加的原因.
It is important to understand that the following problems can be associated with sex chromosome abnormalities:
- 增加流产的风险
- 患有心脏病的婴儿可能需要手术治疗
- 行为或学习障碍的风险增加
- 增加孩子成年后不孕的风险
The risk of having a chromosomal abnormality like Down's syndrome is not increased with ICSI but increases with maternal age.
Several studies have addressed the issue of developmental delays in children born of ICSI. 然而,没有确凿的证据表明这是事实.
我们所有的卵子都要注射吗?
If you decide to proceed with ICSI, we will make every effort to inject as many eggs as possible. It is important for you to understand that only eggs that are mature can be injected with sperm. 我们的试管婴儿实验室可以很容易地判断卵子是成熟还是不成熟. Although the immature eggs are incubated with sperm, the likelihood of fertilization is very low. On average, we are able to inject 75 percent to 80 percent of the eggs that are recovered.
Are there differences in embryo quality or pregnancy rates between ICSI and non-ICSI embryos?
There appears to be no difference in the overall embryo quality achieved with ICSI embryos when compared to non-ICSI embryos. Similarly, no difference in pregnancy rates has been shown between ICSI embryos and non-ICSI embryos. 虽然未经证实的, there is a belief among many infertility specialists that ICSI may increase embryo yield from a given number of eggs recovered, 是什么导致了ICSI手术的增加.
加州大学旧金山分校健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.