Intracytoplasmic Sperm Injection (ICSI)

What is ICSI (Intracytoplasmic Sperm Injection)?

In-vitro fertilization (IVF) is a widely performed assisted-reproductive procedure that helps couples struggling with infertility conceive. ICSI—Intracytoplasmic Sperm Injection is a part of IVF.

The procedure involves all the steps of a standard IVF process except the fertilization. In ICSI, a healthy sperm is selected and injected into the mature egg instead of leaving it in a laboratory dish to fertilize overnight. Intracytoplasmic Sperm Injection is performed in case of male infertility or when the sperm and eggs do not fertilize naturally in an incubator.

ICSI (Intracytoplasmic Sperm Injection)

ICSI Treatment Process

ICSI treatment aims to increase your chances of conceiving through IVF by improving the success rate of fertilization. Here’s the step-by-step ICSI process.

ICSI Procedure Stages

1. Fertility Testing:

Your healthcare provider will order an ultrasound or conduct a physical test to check your reproductive health. They will look for the signs of blocked fallopian tubes, endometriosis, ovarian cysts, and other reproductive conditions that might cause female infertility.
Likewise, the male partner has to send their semen sample to the lab for a thorough examination. Once the doctor has identified the cause of infertility, they will decide whether ICSI is needed.

2. Ovarian Stimulation:

You need to take hormonal shots from the second or third day of your period for 10-12 days to release multiple mature eggs from your ovaries. In each ovulation cycle, a woman’s ovaries release one healthy egg. However, for an IVF procedure, hormonal drugs are used to retrieve multiple eggs, thus increasing the chance of fertilization.

3. Egg Retrieval and Semen Collection:

Egg retrieval involves the extraction of mature eggs from your ovaries through a minimally invasive procedure. On the same day, the male partner is asked to send their semen sample. The doctor will analyze the semen and choose either the natural fertilization process or ICSI (if the sperm count in the semen is low).

4. ICSI Procedure:

Your doctor will select the live, healthy, and fastest-moving sperm and inject it manually into the selected mature egg using a thin needle. The procedure will be performed for multiple eggs to ensure maximum chances of pregnancy.
These united sperm and eggs will be stored in the laboratory dish. If everything goes well, fertilization will occur overnight, and embryos will form.

5. Embryo Culture:

These embryos will be put in a petri dish for 5-6 days following the ICSI procedure. The embryologist creates an environment where embryos can grow normally and reach the blastocyst stage. At this point, your healthcare provider will prepare you for the final step of the fertility treatment, i.e., the transfer of the embryo into your uterine lining.

6. Embryo Implantation:

The healthiest and most competent embryo will grow to reach the blastocyst stage. This embryo will be implanted into the woman’s uterus through a minor procedure. The blastocyst is released into your uterus through the cervix.
In the subsequent days, this blastocyst will attach itself to the uterine lining and develop to form a fetus. You can take a pregnancy test in 7-10 days after the embryo implantation. If, for some reason, the procedure fails, your doctor will repeat it using the frozen eggs.

ICSI is not performed in all IVF fertility cases. It’s needed in the case of male infertility or when the previous IVF cycles have failed. Some ICSI indications include poor-quality sperm, a genetic disorder, ejaculatory dysfunction, and failed fertilization in a standard IVF procedure. ICSI is also performed if the couple chooses PGD (preimplantation genetic diagnosis).

Difference between IVF & ICSI

IVF is a fertility treatment that may or may not involve ICSI. Whether or not your case requires Intracytoplasmic Sperm Injection depends on the quality of the woman’s eggs and the male’s sperm.

The difference between IVF and ICSI lies in the fertilization technique. The former involves placing the egg and sperm in close proximity in a controlled environment, and fertilization occurs naturally when the two combine. ICSI involves manual injection of the sperm into eggs to increase the fertilization chances.
Eggs with thick shells and semen with low sperm count or weak sperm might need ICSI. In both cases, the sperm can’t penetrate the ovum and fertilize the egg naturally, requiring an injectable to manually combine the both. This increases the chances of successful fertilization and, thus, a healthy pregnancy.

IVF

ICSI

Is ICSI Better than IVF Treatment?

ICSI treatment adds to the cost of the IVF procedure. It’s recommended only if the IVF procedure has failed. That’s because this additional step in your fertility treatment requires a suitable environment for fertilization and a professional who can carefully inject the sperm into the eggs. Besides, there’s no 100% guarantee that the procedure will fertilize all healthy eggs.

Who Needs ICSI Treatment

ICSI treatment adds to the cost of the IVF procedure. It’s recommended only if the IVF procedure has failed. That’s because this additional step in your fertility treatment requires a suitable environment for fertilization and a professional who can carefully inject the sperm into the eggs. Besides, there’s no 100% guarantee that the procedure will fertilize all healthy eggs.

People With:
  • Low sperm count, caused by a genetic disorder, an injury, a surgical procedure, or other reasons, making it difficult for the sperm to release from the ejaculate.
  • Poor-quality sperm or frozen sperm that’s too weak to fertilize the egg naturally
  • A history of failed IVF treatment
  • A maternal age of 35 or above with poor egg quality

Success Rate of ICSI Treatment

ICSI can fertilize 50-80 percent of the eggs, but like any medical procedure, there is a chance that the procedure might fail. ICSI is quite effective in increasing your chances of conceiving. However, it’s only a part of the IVF treatment.

There are many factors affecting the outcome of in-vitro fertilization, such as maternal age, genetic disorders in couples, and the mother’s reproductive health. ICSI success rate might contribute to the outcome of IVF procedures, but it alone won’t guarantee a healthy and viable pregnancy.

Risks Associated With ICSI Treatment

While ICSI improves the fertility odds in infertile partners, the procedure comes with risks. Here are some ICSI treatment risks you must be aware of.

  • Damage to the egg due to sperm penetration through a thin needle
  • Fertilization might not occur
  • The embryo can die in the incubator or when it’s implanted into the uterus

Best IVF Center for ICSI Treatment

The success rate of ICSI also depends on the IVF center you choose. Australian Concept Infertility Medical Center is, so far, the best IVF clinic in the country. They have delivered 15000+ babies through IVF and have performed numerous ICSI procedures to increase the fertilization success rate in couples who can’t conceive naturally.

Cost of ICSI Treatment

ICSI is a complex procedure requiring an expert embryologist who can inject sperm into an egg and keep it in a closely monitored environment to achieve the highest success rate for fertilization. The cost of the procedure depends on the clinical or medical history of the patient

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ICSI stands for Intracytoplasmic Sperm Injection. It is a specialized form of in vitro fertilization (IVF) used primarily to treat severe cases of male infertility. During ICSI, a single sperm is injected directly into an egg to facilitate fertilization, which can then be implanted into the uterus. This technique is particularly useful when there are issues with sperm quality or quantity, such as low sperm count or poor motility.

ICSI is more effective than traditional IVF for severe male infertility, improving fertilization rates when sperm quality or quantity is an issue. For cases without significant male factor infertility, both methods have similar success rates. The choice between ICSI and traditional IVF depends on the specific infertility diagnosis and recommendations from a fertility specialist.

Male Factor Infertility: Severe male infertility issues, such as low sperm count, poor sperm motility, or abnormal sperm morphology.
Previous Fertilization Failure: Couples who have experienced failed fertilization attempts with traditional IVF.
Pre-implantation Genetic Testing: When genetic testing of embryos is necessary before implantation.
Certain Female Infertility Cases: Including poor egg quality or unexplained infertility.

The success rate of ICSI treatment in Lahore, Pakistan ranges from 50% to 80%. Specific clinics report success rates of 65% to 70%.

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