the microfertilization It is a laboratory technique in which the embryologist chooses a sperm and injects it directly into the interior of a mature egg, with the help of a special high-resolution microscope and micromanipulation tools.

Unlike conventional IVF, where the sperm are placed together with the eggs and the fertilization is done more "naturally" in the laboratory, in ICSI the process is completely targeted. Each mature egg is fertilized by the direct introduction of a selected sperm.

This method is particularly useful when the number, motility or morphology of spermatozoa does not allow fertilization in a conventional way. In the event that the characteristics of the sperm are satisfactory, the choice of spermatozoa in relation to morphology and motility, with the help of strong microscopes, increases the probability of success.

Microinsemination is mainly recommended in cases where there is a serious male infertility factor or when there are indications that conventional IVF may not lead to satisfactory fertilization of the eggs.

ICSI can be recommended in cases such as:

• oligospermia, when the number of sperm is very low.
• asthenospermia, when spermatozoa show reduced motility.
• teratospermia, when a large percentage of sperm show morphological abnormalities.
• Severe male infertility factor, where natural fertilization or conventional IVF is difficult to achieve.
• Azoospermia, as in the case where the sperm is surgically taken from the epididymis or testicle.
• Occlusion of the spermatic tracts, where there are no sperm in ejaculation but can be recovered surgically.
• High levels of antisperm antibodies, which may affect the ability of sperm to fertilize the egg.
• Previous Fertilization Failure in an IVF cycle.
• Low or zero fertilization rate In a previous IVF attempt.
• Increased fragmentation of sperm DNA, when this is considered important by the specialist and the embryologist in the context of the overall evaluation.

The choice of microinsemination should not be made mechanically, but after a complete assessment of the couple. In some cases it is the most appropriate choice, while in others it can be combined with additional techniques or a different therapeutic design.

Microinsemination offers significant advantages, especially in cases where sperm presents serious disorders.

Its main advantage is that a very small number of spermatozoa is required. Even when there is little sperm available, such as in cases of sperm recovery surgery, ICSI can allow fertilization of the eggs.

Also, the technique allows the laboratory to select sperm with better mobility and morphology, increasing the chances of fertilization in cases where conventional IVF may not be sufficient.

Microinsemination is therefore a valuable option for couples with a serious male factor, a previous failure to fertilize or the need to use surgically recovered sperm.

chances of success of microinsemination

The success rates of microinsemination depend on many factors and are not the same for all couples.

Egg fertilization with ICSI can be achieved at high rates, often about 65% to 75% of mature eggs, when there are appropriate conditions. However, the fertilization rate is not necessarily identical to the pregnancy or birth rate of a child.

The final success of a cycle depends on factors such as:

• the woman's age,
• the quality of the eggs,
• Manipulation of preparation before ovulation to obtain mature eggs
• The greater number of eggs that can be taken for the woman's data to increase the statistical fate of the project
• the quality of the sperm,
• Response to drug stimulation,
• The quality of the embryos
• the condition of the uterus and endometrium,
• Design, experience and attention during embryo transfer
• history of previous attempts,
• The cause of infertility.

For this reason, each couple should be informed individually. The responsible medical approach is not based on general promises, but on a realistic assessment of the data of each incident.

Microfertilization and male infertility

ICSI is one of the most important developments in the treatment of male infertility. In cases where sperm presents serious problems with numbers, motility or morphology, microinsemination can give the possibility of fertilization which would otherwise be extremely difficult.

It is also of particular importance in cases of azoospermia, where there are no sperm in the ejaculation, but they can be recovered surgically from the testicle or epididymis. In these cases, ICSI is usually the method that allows the use of even a very small number of sperm.

The successful treatment of such cases requires proper cooperation between reproductive specialist, urologist/andrologist and embryological laboratory. The design should be careful, especially when the available sperm is limited or taken with surgical recovery.