Video Games and ICSI

As a teenager growing up in the Boston suburbs I spent a lot of my Saturdays in Harvard Square playing video games at the arcade that was next to the Orson Wells Theatre. My kids can’t imagine why I would go into Boston to play video games. They can’t believe that there was no Nintendo, no Playstation, and no X-box at my home . They laugh at the screen shots from my Atari. I still remember spending a lot of money feeding quarters into the Defender game or Robotron or Galaga. My Dad thought this was a complete waste of time, but in fact it was some of the best medical training that I ever received. Laparoscopy is really similar to a video game. ICSI also requires video game skills. Watch the embryologist catch a sperm. Watch him crimp the sperm tail and load it into a micropipette. Watch him inject the sperm using a smooth motion and release the sperm into the middle of the egg. Score one for the good guys...

So for those who have no idea what I am talking about, the “Question of the Day “ is all about ICSI (pronounced ick-sea). Or you can skip this blog and just go to Amazon.com and preorder the book!



57. What is ICSI, and how does it differ from IVF?


In routine IVF, eggs are placed in a laboratory dish in culture media together with prepared sperm. The eggs and sperm are allowed to spontaneously fertilize and grow until the embryo transfer procedure, which is usually performed 3 to 5 days after the egg retrieval. Intracytoplasmic sperm injection (ICSI) differs from IVF in that each egg is individually injected with a single sperm using a tiny needle under microscopic guidance (Figure 4). The resulting embryo is then cultured similarly to an embryo produced in a non-ICSI IVF treatment. ICSI was initially introduced by the IVF team working at the Brussels Free University in Belgium. At that time, assisted fertilization was being attempted through the insertion of the sperm under the eggshell (zona pellucida). The Belgian group took the extra step of injecting the sperm not only under the eggshell but actually into the middle of the egg itself. The first ICSI pregnancies were reported in 1992. Since then, tens of thousands of children have been born as a result of this unique procedure. Both ICSI and non-ICSI IVF have similar pregnancy rates and outcomes. The embryos produced by either method should not be considered to be superior to those created with the other. ICSI is simply a method to ensure that the egg is fertilized. ICSI is a safe and proven IVF method that does not increase the likelihood that the child conceived in this way will have a birth defect.