Orlando: 407-281-9229 or To Schedule An Appt: Contact Us Online
Reproductive Medicine Institute - Dr. Fernando Gomez, Infertility and IVF Doctor in Orlando, Florida
Home Medical Services Our Physician Location Finances Scheduling The ARC Advantage Contact   english español

The Reproductive Medicine Institute (RMI) is a leading medical practice in Central Florida devoted to the diagnosis and treatment of infertility.
The Reproductive Medicine Institute (RMI).  Orlando Infertility and IVF.
Intracytoplasmic Sperm Injection (ICSI)

In many circumstances for couples who cannot become pregnant, the reason can be identified as male factor infertility. Diagnoses in this category include azospermia, low count and/or motility, post vasectomy and spinal cord injury related infertility.

If male factor infertility can be identified as the issue, a popular option is the highly successful technique of injecting the sperm directly into the egg to increase the chance of fertilization. This procedure, known as Intracytoplasmic Sperm Injection (ICSI), is performed by a highly trained laboratory specialist with many hours of certification in this area.

If no sperm are available due to spinal cord injury, vasectomy or other reasons...Dr Gomez  will work closely with Urologists who can obtain sperm through testicular biopsies or other surgical procedures allowing these patients for whom this would not be possible otherwise the opportunity to father a child.

ICSI- The Process

After the eggs are retrieved in an IVF cycle, they are separated from the follicular fluid, placed in a Petri dish, and examined under a microscope. The embryologist uses a micromanipulator to hold the egg in place and orient it correctly.

In the ICSI procedure, a small hole is made in the zona pellucida (egg membrane) using microscopic tools and the sperm is inserted directly into the egg. Puncturing the egg in this controlled manner does not cause damage. After insertion of the sperm (intracytoplasmic sperm injection), the embryos are placed in incubators until ready for transfer.

ICSI requires that sperm be obtained from the ejaculate if the male has sufficient quantity and quality of sperm. When adequate sperm are not available, PESA or TESA can be utilized in conjunction with intracytoplasmic sperm injection.

ICSI combined with PESA (percutaneous epididymal sperm aspiration) is a noninvasive method of sperm recovery and has excellent potential for patients who have had a vasectomy and do not wish to undergo surgical reversal, or patients who have had a reversal that failed. intracytoplasmic sperm injection success rates per cycle exceed those associated with a vasectomy reversal. A vasectomy should always be considered a permanent means of birth control.

ICSI combined with PESA requires that a small needle be placed into the epididymis, using local anesthesia, to withdraw the sperm. The epididymis normally serves as a reservoir for sperm. This technique would also be applicable for patients with congenital absence of the vas deferens, previous infection with resultant occlusion of the epididymis, and ejaculatory dysfunction due to multiple sclerosis or diabetes.

ICSI with TESA (testicular sperm aspiration) is useful for men who have non-obstructive azoospermia caused from maturation arrest disorders and for patients in whom sperm could not be obtained through the PESA procedure. Using TESA, sperm are obtained by biopsy of the testicle. It is possible to obtain sperm using TESA even when there are none seen in the ejaculate.

ICSI combined with TESA is relatively simple, the equipment required is minimal and the procedures are much less invasive than the previous microsurgical approaches. The patient is able to return to work either the same or the following day without significant risk of complications.

ICSI has been offered for many years. To date, there has been no association with an increased risk of birth defects. In addition to moderate to severe male factor, intracytoplasmic sperm injection is often recommended in cases of advanced female age, unexplained infertility, and other conditions as deemed appropriate by the physician.

For more information about the ICSI, PESA or TESA process or to be evaluated by Dr. Gomez and The Reproductive Medicine Institute staff, please call us at 407-281-9229.

We look forward to serving you.

The Reproductive Medicine Institute (RMI).  Orlando Infertility and IVF.

Reproductive Medicine Institute | 7806 Lake Underhill Rd Suite 105 | Orlando, FL 32822 | Office: 407-281-9229 | Fax: 407-207-7180 | Email:

Copyright © 2007 - 2009 Reproductive Medicine Institute. All rights reserved.

System Login