In scientific terms, the natural fertilization process involves the penetration of a single sperm from the ejaculated semen into egg commonly known as oocyte which is released into the fallopian tube during ovulation. It is important that the sperm must penetrate the covering of the egg in order to fuse immediately with the female gamete. However, sometimes either due to biological deficiencies, reduction in the gametes productions, poor gamete quality or due to some fault in sperm and egg interaction, the fertilization process can be prevented and results in infertility.

But thanks to the recent advances in the medical science, we can now overcome these deficiencies by two main approaches in Assisted Reproduction Techniques (ART). These approaches are Conventional In-Vitro Fertilization (IVF) and Intra Cytoplasmic Sperm Injection (ICSI).

Intracytoplasmic Sperm Injection, commonly called as ICSI, is an advanced and most commonly used technique of IVF. In this procedure, your partner’s sperm is injected directly into your egg for fertilization in-vitro. ICSI technique is done to insert a healthy and single sperm directly into an oocyte and thus surmounting the limitations of conventional IVF like poor semen samples, male infertility issues or problems in the interaction between female and male gamete during fertilization.

This procedure is successfully performed with the assistance of an advanced micromanipulation technique, which comprise of a microscope, micro-injectors and micro-pipettes. With the help of these equipment’s, a single healthy sperm is isolated, selected and immobilized. After this, the oocyte is held during microinjection and that selected sperm is inserted and released inside the inner part of the oocyte. After microinjection, each oocyte is continually checked for the signs of successful fertilization.

The ICSI procedure is considered as the revolutionary procedure since it virtually guarantees the successful penetration of sperm into an egg. With the capability to fertilize an egg with just one sperm, the couples facing infertility issue can consider ICSI as one of the promising option to finally become pregnant.

Intracytoplasmic sperm injection (ICSI) procedure is an advanced form of IVF which is performed using a specialized technique called as micro-manipulation. This technique uses a special microscope along with other surgical tools like micro-injectors and micro-pipettes to select and handle a single healthy sperm and injecting it directly into an egg.

The steps for ICSI procedure are somewhat similar to the IVF procedure except the phase of fertilization.

The phases for ICSI procedure are described below:

• Phase 1: Ovarian Stimulation
  Normally, a woman produces one egg during each menstrual cycle. Like IVF, for ICSI as well we need multiple eggs since it increases the chances of developing a viable embryo. In order to achieve that, during the stimulation phase, a woman will be give daily injections of fertility medications for 9 to 11 days. This will boost the egg production and enables the ovaries to produce several eggs in one cycle. During this period, the fertility specialist will perform regular blood investigations and ultrasound so as to monitor the production of eggs and to determine the perfect time to retrieve them.
• Phase 2: Sperm Extraction
  A sperm sample from your partner can be taken in two ways. Either directly through semen collection or we can extract the sperms surgically from your partner’s testes or epididymis in case of poor sperm count and quality.
• Phase 3: Egg Retrieval
  Egg retrieval also known as follicular aspirations is small surgical procedure performed under anesthesia. Under the guidance of ultrasound, the surgeon will pass a thing needle through the upper portion of vagina into your ovary and into an egg-containing follicle. This needle will then aspirate the eggs and fluid out of each follicle. The recovery after this procedure is usually rapid and you will be monitored for next 1 hour after the procedure before going home. Some women may experience mild cramping on the day of retrieval which usually subsides by the evening of retrieval.
• Phase 4: Fertilization of Eggs and Sperm with Micromanipulation
  In this phase, semen sample is taken from the male. The eggs are identified and isolated from the follicular fluid and placed in an incubator. Later, these eggs are fertilized with sperm by Intracytoplasmic Sperm Injection (ICSI) technique. The embryologist picks up a single sperm under microscope and injects it directly into the egg cytoplasm using a small glass needle called as microinjection.
• Phase 5: Embryo Culture
  This egg is then monitored to document fertilization. Once fertilized, the egg starts dividing and develops into an embryo. The embryologist keeps a close check on embryo to make sure it matures properly. On day two or three after fertilization, the embryos will be evaluated for blastocyst culture. The embryos are then grown for five or six days until they reach the blastocyst stage.
• Phase 6: Embryo Transfer
  This is a painless procedure in which the embryo is placed into the uterus through a highly specialized catheter under the guidance of ultrasound. No sedation is necessary for this procedure and is usually done 3-5 days after fertilization. After this embryo transfer, progesterone supplementation via injection or vaginal suppository will be given for next 10-12 days and a blood pregnancy test will be performed approximately 2 weeks after the egg retrieval date.
• Phase 7: Implantation and Pregnancy Test
  A successful pregnancy occurs when the embryo implants itself into uterine wall called as endometrium. This can take 6-10 days after embryo transfer phase. Then the initial pregnancy test is performed to determine if you are pregnant. Once the viability is confirmed, you will be referred the Obstetric and Gynecologist for appropriate prenatal care.