Although reports on microsurgical epididymal sperm aspiration with IVF appeared in the literature as early as 1984, the first live birth was not reported until 1990. As it was first described, the procedure of microsurgical epididymal sperm aspiration involved careful dissection of the epididymis under the operating microscope and incision of a single tubule.
Once incised, fluid spills from the epididymal tubule and pools in the epididymal bed. This pooled fluid is then aspirated. Because the epididymis is richly vascularized, this technique invariably leads to contamination by blood cells that may …

It is sometimes also called sperm preparation or spinning. It is a laboratory technique for separating sperm from semen, and separating motile sperm from non-motile sperm, for use in assisted reproduction (IUI, IVF).
The washing technique for near normal specimens is mixing the ejaculate after liquefaction with the appropriate washing medium followed by centrifugation. (A centrifuge is a machine that separates materials with different densities by spinning them at high speed.) The supernatant is discarded and the sediment (sperm rich fraction) is re-suspended in more washing medium. This process is repeated …

In certain cases, manipulation of the embryo can enhance implantation and subsequent pregnancy. Common practice is to use acidified Tyrode’s solution (pH 2.35) to thin the zona pellucida. An increase in implantation from 18 % to 25 % is achievable for oocytes with poor prognosis with this intervention, refeffed to as assisted hatching. Assisted hatching is not applicable only for male factor infertility, in fact, it is a treatment for specific defects in embryo development or oocyte abnormalities. However, it is a micromanipulation technique that is routinely performed during IVF …

Risks of IVF-ICSI include general risks of IVF as well as the specific risks related to the micromanipulation procedure of ICSI. One of the most significant risks associated with stimulation of the ovaries is the ovarian hyperstimulation syndrome (OHSS). This can manifest as massive ovarian enlargement, peritoneal irritation due to follicular rupture or hemorrhage, ovarian torsion, ascites, pleural effusion, oliguria, electrolyte imbalance, hypercoagulability3l I and sometimes death36 . The syndrome occurs in a moderate form for 3-4% percent of initiated cycles, and in a severe form for 0. 1-0.2 % …

One of the largest series reporting results using IVF/ICSI was from Van Steirteghem et al. at The Brussels Free University in Brussels, Belgium. In their preliminary report on 150 couples who underwent 150 consecutive treatment cycles, 1409 oocytes were injected and 830 were successfully fertilized for a fertilization rate of 59 percent. A total clinical pregnancy rate of 35 percent was achieved. The fertilization rate in this study was not influenced by the standard semen characteristics of concentration, motility, and strict criteria morphology. In another largest case serie on ICSI …

Intra-cytoplasmic sperm injection (ICSI) is a relatively new but well-established procedure first performed in 1992. The procedure was developed to help male factor infertility. The procedure involves injecting a single sperm into the cytoplasm of each egg using a fine glass needle. The first ICSI baby was reported in 1992. The ICSI has largely replaced the two previously developed procedures, PZD (partial zona dissection) and SUZI (subzonal insemination) because it achieves much higher fertilization rates.
The injection of immature sperm (spermatid) into the egg is not allowed in the UK because …

For some couples undergoing IVF, one of the most significant ethical issues they may face is the fate of the surplus embryos.
Following embryo transfer, any remaining viable embryos are then cryopreserved (frozen) for later transfer. Not all embryos are suitable for freezing. The embryos can be frozen at the pronucleate, early cleavage or blastocyst stage. Overall about 50% of frozen embryos survive the thawing process. In the United Kingdom, the embryos can be frozen for up to 10 years with the intent of thawing and transferring them at a later …