Is ICSI Required For PGS & PGD?

PGS & PGD Aren’t The Same

We should make the distinction here between PGS and PGD. In PGS (or CCS) there is debate whether ICSI is necessary. In PGD, for the moment, there is no debate: ICSI must be used.

PGS (Pre-implantation Genetic Screening)

We have a rich course on PGS but here is the crux as it pertains to ICSI. PGS theoretically helps the doctor determine whether an embryo is chromosomally normal (or not) so the doctor can prioritize which embryo(s) to transfer. To get this information, an embryologist must cleave a few cells from the outer layer of an embryo for analysis.

Most patients who want PGS performed on their embryos are told this is only possible if those embryos were created using ICSI. There is debate on that point.

Pro-ICSI Argument

The argument for using ICSI when doing PGS is that it makes PGS more accurate. When eggs are fertilized during CI, they are surrounded in a petri dish with droplets that contain sperm that compete to fertilize the egg. As a result, sperm may get stuck to the outside of the egg and leave their genetic residue behind.

The fear is when the PGS biopsy is performed, residue on the outside of the egg (now an embryo) may get included and confuse the analysis. In theory, ICSI eliminates this risk because a single sperm is injected directly into the egg with no residue left on the egg / embryos outside.

Anti-ICSI

Some doctors disagree and point to the lack of data behind the pro-PGS assertions. They believe PGS is accurate enough that it won’t be thrown off by potential residue of other sperm.

Next