Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technique (ART) used with traditional IVF treatment in the case of severe male infertility such as oligospermia, low sperm motility and poor sperm morphology. ICSI treatment is more effective than IVF treatment for male infertility factors.
Generally, IVF treatment is suggested for couples struggling with infertility after IUI failure. However, if the sperm of the male partner cannot fertilize the female partner’s egg naturally, then ICSI is suggested. The ICSI can overcome the limitation of IVF treatment in case of male factor infertility. For this reason, IVF-ICSI is preferred to circumvent IVF failure related to sperm issues.
What is ICSI Treatment?
Unlike traditional IVF treatment, in ICSI treatment, the eggs are manually inseminated by the sperm. As the name suggests, in ICSI, the sperm is artificially injected into an egg’s cytoplasm with specially designed medical equipment in the laboratory.
How are ICSI and IVF different? And is ICSI treatment more effective than IVF treatment?
The only difference between conventional IVF and IVF-ICSI treatment is the fertilization methods. Conventional IVF treatment uses a “natural” fertilization technique, where eggs and millions of sperm are placed in a petri dish. Then the sperm will penetrate the outer shell around the egg and fertilize it on its own. In Intracytoplasmic sperm injection, however, sperm is literally injected into an egg with the help of a microinjection pipette under a microscope, and we can call it assisted insemination fertilization.
The ICSI treatment is more effective in terms that there will be more fertilized eggs than in a conventional IVF treatment. It is observed that, for men with severe male factor infertility, there are 60-80% chances of fertilization with ICSI compared to less than 50% chances of fertilization with only IVF. And if there are more fertilized eggs, then more quality embryos can be developed for embryo transfer.
This is why ICSI is commonly suggested with IVF to couples where the male partner has a severe case of infertility, and his sperm cannot fertilize the eggs by itself.
Who Requires ICSI Treatment with IVF Treatment?
ICSI technique is used with IVF treatment in case of severe male infertility such as:
- Low sperm count
- Poor sperm motility
- Sperm with abnormal shape and size
- Unknown cause of male infertility
- Erectile dysfunction and azoospermia
- Vasectomy and varicocele
- Couple with previous IVF cycles failure
The procedure of ICSI Treatment
The procedure of ICSI treatment is similar to IVF treatment, and the only modification is in the fertilization step. Your fertility expert will decide whether the patient needs an ICSI treatment with IVF through semen analysis of the male partner. The ICSI procedure follows as:
- Ovulation hyperstimulation: The production of multiple eggs is stimulated in women by administering hormonal medications and injections. Multiple eggs favour the process of fertilization and embryo development, as well as quality control during the IVF cycle.
- Egg Pick-up (EPU): Once the size of follicles in the ovaries is between 16-18 mm, the eggs are ready for ovulation. An hCG trigger shot is recommended 36 hours before the egg pick-up. The eggs are retrieved from ovaries with the help of an ultrasound-guided needle. The procedure is pain-free as it is performed under anaesthesia and only takes 30-40 mins maximum.
- Male partners are asked to provide sperm samples (by musterbation) on the same day of Egg pick-up. If a partner has erectile dysfunction or other ejaculatory condition, then the sperms are aspirated from the testicles by TESA or PESA.
- ICSI Fertilization: This is an important step in ICSI treatment. In this step, the eggs are first denuded chemically or mechanically. Healthy sperm are selected for ICSI. The denuded eggs are inseminated one at a time by injecting the sperm into their cytoplasm using a microinjection pipette under a powerful microscope. The inseminated eggs are evaluated and placed in a Petri culture inside an incubator for fertilization. The fertilization can take 20-24 hours.
- The fertilized eggs start to grow into multicellular embryos day by day inside the incubator. It can take 3-5 days for an embryo to develop up to the stage reliable for implantation.
- Embryo transfer: Once embryos are developed, they are ready to transfer to the uterus for implantation. The embryo transfer is performed 3-5 days after fertilization. The embryologists select quality embryos for transfer. One or more embryos are placed inside the uterus for implantation using a catheter.
- Implantation and Pregnancy: The embryo embeds itself on the uterine lining for fetus development, and presumably, after two weeks of embryo transfer, pregnancy can be detected.
Some treatments, such as PGS, might be required for embryo assessment in case of multiple IVF failures in the past.
IVF-ICSI Treatment at Risaa IVF
Our clinic offers various infertility treatments, including IVF and ICSI. We have more than 30 years of experience in fertility health. With the help of ARTs, we have helped hundreds of couples to achieve pregnancy. Our fertility team of experienced doctors, embryologists and nurses work towards success without compromising the quality and well-being of our patients. We have achieved one of the highest ICSI success rates (above 50%).
Contact us for more queries regarding ICSI and IVF, and visit our clinic Risaa IVF, Delhi.
Is there any risk of ICSI treatment?
Yes, ICSI treatment is safe. The children born through ICSI and IVF are mostly healthy. However, as the sperm is assisted in inseminating the eggs, they might be equally efficient as sperm that naturally inseminate eggs; therefore, in some rare cases, children may be born with congenital disabilities. This factor is common in IVF and ICSI.
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