CAN WE MAKE INTRACYTOPLASMIC SPERM INJECTION (ICSI) SAFER AND MORE EFFECTIVE?
Intracytoplasmic sperm injection (ICSI) is an in vitro assisted fertilization procedure in which a single sperm is injected directly into the oocyte. Since its introduction in the early ‘90s, ICSI has revolutionized the treatment of male infertility, becoming a rapidly accepted technique worldwide. Today it is the most commonly used assisted reproductive procedure that has resulted in the birth of millions of babies. ICSI is a multistep, invasive micromanipulation technique that bypasses all the initial steps of natural fertilization providing the most reliable and consistent chances of oocyte fertilization, but at the same time it brings potential risks, primarily of oocyte degeneration, but also of transmission of chromosomal abnormalities that are more frequently associated with male infertility. Many steps are not fully understood and because there is no optimal ICSI protocol, we will discuss different approaches and current knowledge that can potentially improve ICSI outcome.