New Advances in Intracytoplasmic Sperm Injection (ICSI)

In these last twenty years, intracytoplasmic sperm injection (ICSI) has efficiently permitted the treatment of male factor infertility (Van Steirteghem et al., 1993); the direct injection of spermatozoa into ooplasm has allowed the embryologist to overcome low sperm motility, poor sperm-Zona Pellucida (ZP) binding, and defective acrosome reaction. Although ICSI has been successfully applied worldwide for several years, nevertheless we have no real knowledge regarding the hypothetical long term side effects on ICSI adults. In fact, some doubts about the safety of this technique can arise (Oehninger, 2011) due to the fact that with ICSI some check points of natural fertilization are bypassed and that some steps differ considerably from the physiological process; For instance, the introduction of the sperm tail into the ooplasm may cause sperm nuclear decondensation problems (Dozortsev et al., 1995; Markoulaki et al., 2007). It should be considered that ICSI may increase the risk of injecting spermatozoa with genetic or functional anomalies (Sakkas et al., 1997; Bonduelle et al., 2002; Marchesi & Feng, 2007; Schatten & Sun, 2009; Heytens et al., 2009; Navarro-Costa et al., 2010). For these reasons and to minimize any risk related to ICSI, any new advance in this procedure which can help the operator to restore some of the basic physiological checkpoints and to simulate the natural fertilization process should be welcome (Parmegiani et al., 2010a).