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  11. Sperm microinjection

Spermatozoa for ICSI
Until recently the treatment of male infertility was difficult, unpredictable and had high failure rates. As improvements in IVF took place, more and more units found that they could often get the sperm from infertile men to fertilise eggs by a number of different microsurgerical techniques in the laboratory. In particular, sorting out the "good" sperm by using special solutions of medium. Drugs to enhance sperm mobility (such as pentoxyfylline) have also had some modest success, though the advantages of such drugs are less clear.

The latest advance has been ICSI, or "Intra Cytoplasmic Sperm Injection". In this technique, a single sperm is picked up in an extremely fine glass tube and injected right into the centre of the egg. Remarkably, this has resulted in a very high fertilisation rate even in some of the very worst cases - in men where nobody would ever imagine that fertilisation could occur.

Preparation for ICSI
All these concerns are real ones, but so far there has been no indication that the children born as a result of this technique are anything other than completely healthy. At the time of writing, well over a thousand babies have been born worldwide after ICSI, and there is not the slightest evidence that there is any increased risk of children been born abnormal. Of course more work is needed, and research is actively going on in our own laboratories.


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