ICSI Treatment

icsi

What is ICSI?

ICSI (pronounced as ick-see) also known as Intracytoplasmic Sperm Injection, is a specialized form of IVF (In-Vitro Fertilization), in which a single healthy sperm is directly injected into the cytoplasm of the egg. It is most commonly done when a couple is unable to conceive due to male infertility or have experienced IVF failures in the past. ICSI is used when, unlike natural conception, the sperm is not able to attach itself to the egg and fertilization does not take place. 

What is the difference between ICSI and IVF?

ICSI and IVF, both are very common treatments for infertility. ICSI is considered as a type of IVF but still has a key difference, i.e how the sperm fertilizes with the egg. Fertilization for both treatments take place in the lab, in IVF, multiple eggs and sperm are left in a petri dish to fertilize on their own. In ICSI, a single sperm is taken and directly injected into the egg for fertilization.

Both the treatments have helped many infertile couples achieve the dream of parenthood.  

Just like in IVF, in ICSI treatment, the female partner is given fertility medication to stimulate the ovaries to produce multiple eggs for fertilization. Once matured, these eggs will be retrieved and kept to be used immediately or frozen for future use. 

In the meantime, the sperm is taken from the semen sample collected from the male partner. And a single healthy sperm is collected after washing it.

This sperm is then injected into the cytoplasm of the cell with the help of a thin needle under a microscope. And this fertilized egg (embryo) is placed in the uterus of the female partner after 3 to 5 days, where it will get attached to the uterus lining for further growth. 

Why is ICSI treatment done?

Mostly used in the cases of male infertility, ICSI treatment is done when-

  • Sperm count is very low (Oligospermia)
  • Sperm has poor motility i.e. slow movement (Asthenozoospermia)
  • Sperm has poor morphology i.e. abnormal shape (Teratozoospermia)
  • Vasectomy
  • Previously failed IVF cycle(s)
  • Unexplained Infertility 
  • Damaged or blocked fallopian tubes
  • Ovulation disorders 
  • Endometriosis 
  • Genetic disorders

What is the procedure of ICSI treatment?

ICSI Procedure-

  • Ovarian Stimulation

To stimulate the growth of follicles containing eggs, the female partner will be given medication. This medication will trigger the ovaries to grow multiple eggs.

  • Egg Retrieval

After administering the final injection, the eggs will be retrieved from the ovaries and taken to the lab for fertilization with the sperm to form a zygote.

  • Sperm Retrieval and Selection

The semen sample is taken from the male partner, from which sperm is retrieved. A motile sperm is selected and prepared for insemination. Embryologists make sure that the sperm selected is of good quality and can be injected into the cytoplasm of the egg. 

  • Fertilization

After both sperm and eggs have been retrieved and selected, the sperm will be inseminated in the egg for fertilization, to form an embryo(s).

  • Culture 

After fertilization, the embryo(s) will be kept for 2 to 5 days in the lab for growth. 

  • Embryo Transfer

 Once an embryo has been selected, it will be transferred to the female partner’s uterus. For this, the embryo will be put inside a catheter which is passed into the uterus through the cervix, where it is gently released to implant itself on the uterus wall. In some cases, more than one embryo is implanted.

  • Pregnancy Test

After 2 weeks of embryo transfer, a pregnancy test is done to check whether conception is achieved.

What is the success rate of ICSI treatment?

ICSI is considered one of the most successful ART methods for problems related to male infertility. The rate of success in ICSI is around 85%, couples with male infertility who opt for ICSI have a success rate of 70% to 75%. The chances of a positive outcome in ICSI is similar to the probability of achieving pregnancy via normal sperm and other conventional methods.

ICSI success rate is high as the doctor can select the best quality sperm and egg for fertilization. However, there are certain factors that determine the ICSI success rate in India, like- the quality of eggs, age of the female partner, type of infertility problem, and sperm quality.

What are the risks involved in ICSI treatment?

Generally, ICSI is considered a safe procedure with minimal risks. However, there are certain risks and disadvantages which should be kept in mind if one wants to opt for ICSI treatment. They are-

  • A male child born with the help of Intracytoplasmic Sperm Injection (ICSI) is more prone to fertility issues in the future. This happens due to the passing of infertility genetics from the father to the baby.
  • There are up to 3% chances of a major birth defect in an ICSI baby. They are-  Beckwith-Wiedemann syndrome, Angelman syndrome, sex chromosome abnormalities, and hypospadias. 
  • Some fertilized eggs (<2%) do not grow into healthy embryos. This is because they might get damaged during the ICSI procedure as it is more invasive and requires more work as compared to a standard IVF procedure.
  • To increase the chances of achieving pregnancy, multiple embryos are implanted inside the uterus of the woman, so that at least one embryo can develop properly. However, this increases the chances of multiple pregnancies. 
  • Multiple pregnancies can further increase the chances of complications like- early labour, high blood pressure, gestational diabetes and the need for a c-section.

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