WHAT IS ICSI?
ICSI is used to treat severe cases of male-factor infertility. The treatment involves the use of specialized micromanipulation tools and equipment that allow embryologists to identify and remove individual sperm with a special needle. The sperm is then injected into the inner part of the egg. It is used in nearly half of all IVF treatments and offers the most successful type of treatment for men who are infertile.
IVF with the eggs of the female partner and sperm of the male partner
Visit by Patients for Medical Examination
Both the male and female partner must visit the clinic for a thorough medical examination and blood tests. They’ll also meet with an embryologist who will explain the options available to address issues related to sperm.
The female partner needs to visit on day two or three of her menstrual cycle, when hormonal investigations are done along with an ultrasound. The ovaries are stimulated with medication to promote the growth of follicles containing the eggs; this process can last for eight to 12 days. The response of the ovaries (quantity and quality of follicles recruited) is monitored through ultrasounds and blood investigations at regular intervals.
After eight to 12 days of taking the medicine, an injection (trigger) is administered to assist with the final maturation of the egg and loosening of the egg from the follicular wall. The patient must visit the clinic for the egg retrieval process, which will be performed 34-36 hours after the trigger administration. Egg retrieval is a day care procedure that is performed with ultrasound guidance under mild sedation to make it painless. The eggs are then retrieved and processed by an embryologist.
On the same day, the male partner provides a fresh semen sample, which is analyzed and processed by an embryologist. In this procedure, sperm processing (post ejaculation) is different. If required, sperm can be extracted from a testicle or epididymis in a separate procedure. Sperm can also be collected over a period of time and stored to be used on the stipulated day of egg collection.
In this step every mature egg is given a single sperm. There are different procedures the laboratory can use to fertilize the collected eggs. The selection of the procedure or combination of procedures to be used by the embryologist is based on the past history and the present status of the gametes. All details are explained to the patient in their appointment with the embryologist, prior to the cycle. One of these procedures is intracytoplasmic sperm injection (ICSI) and another is physiologically selected intracytoplasmic sperm injection (P-ICSI). The semen sample is processed in the andrology laboratory and evaluated prior to its use. After the sperm is injected into the egg, the egg is cultured in an incubator and checked for fertilization after 16 to 18 hours. Once the egg is fertilized, it’s referred to as an embryo, which is then cultured in the embryology laboratory for three to five days.
Based on the quantity, quality and growth of cultured embryos, the embryologist selects the best embryo and an appropriate day for transfer into the uterus of the female partner.
After the embryo transfer, specialists may prescribe medicines to enhance the chances of embryo implantation. After the stipulated period of time, pregnancy tests are conducted to confirm pregnancy.