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ICSI

ICSI- Intra Cytoplasmic Sperm Injection

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.

Causes

ICSI treatment procedure is a potential option for a couple to conceive especially when they are facing male infertility issue.

Some of these problems are mentioned below:

  • Low Sperm count
  • Poor Sperm Quality
  • Poor Sperm Motility due to which sperm is unable to penetrate and fertilize an egg
  • Any abnormality or blockage in the male’s reproductive tract that affects the normal production or ejaculation of sperms

Other than the male infertility issues, there are several other causes which may lead to infertility in the couples and ICSI can be helpful for them if they have not been successful in conceiving with the IVF in previous cycles.

Enlisted below are few of such conditions :

  • Ovulation disruptions: Disturbance in the ovulation owing to infrequent, irregular or absent menstrual cycle results in lesser number of eggs available for fertilization.
  • Fallopian tube blockage or damage: Blockage or impairment in the fallopian tubes makes it difficult for an egg to get fertilized or for a fertilized embryo to propagate through tube to the uterus.
  • Premature Ovarian failure: It is termed as loss of normal ovarian function before women turns 40 years of age. In such cases, the ovaries fail to produce normal amount of estrogen hormone and to release matured egg regularly.
  • Endometriosis: This occurs with the uterine wall tissues starts growing outside the uterus thereby affecting the normal functioning of ovaries, fallopian tubes and uterus.
  • History of tubal sterilization or removal: Tubal ligation is a type of sterilization procedure wherein the fallopian tubes are either blocked or cut to permanently prevent pregnancy. In such cases, if the female wish to conceive, IVF can be an alternative solution rather than a tubal ligation reversal procedure.
  • Unexplained infertility: In cases where there has been no known cause of infertility in spite of doing all the evaluations, ICSI can be the solution.

Intra Cytoplasmic Sperm Injection Procedure in India

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.

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The phases for ICSI procedure are described below:

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.

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.

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.

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.

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.

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.

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.

Are you a Candidate?

ICSI is usually indicated in couples presenting alterations in the semen analysis like low concentration and motility of the viable sperms. You can also be considered for ICSI procedure if you are facing ovulatory dysfunction, diminished ovarian reserves, tubal issues, uterine problems, premature ovarian failure, endometriosis and unexplained fertility. ICSI can also be helpful if you have not been successful in conceiving with the conventional IVF in previous cycles.

Expected Results

One cycle of ICSI takes about 4-5 weeks to complete and often boost the success rate of conception for couples facing male infertility issues. The outcome of ICSI is overwhelming since the doctor injects a single sperm directly into an egg which guarantees fertilization of egg and sperm and thereby increases the chances of successful conception.

Recovery Timeline

Recovery timeline for ICSI is similar to IVF treatment. One cycle of ICSI takes about 4-5 weeks to complete. It includes the steps like ovulation induction, egg retrieval, sperm retrieval, fertilization using micro-manipulation and embryo transfer. You would need to stay in India for 4-5 weeks for one cycle, after which the pre-natal care can be continued in your country.

Cost of ICSI Procedure

India is one of the most affordable places for ICSI treatment across the globe. We certainly understand that if you have chosen to travel overseas for your ICSI treatment, then you are indeed looking for cost effectiveness. When you speak about the best, MedicoExperts is the name you can trust on. Modern technology, State of the art hospitals, most coveted gynecologist and fertility specialists, excellent infrastructure at par with international standards, no language barrier, personalized attention, safe surgery and seamless travel are some of our zeniths which magnetizes individuals worldwide to get their Infertility treatment in India done through us.

We are thus committed to offer you the best possible and special negotiated prices for your ICSI treatment without compromising on the quality of medical services and results. Here’s a look at the approximate costs of ICSI treatment in India:

Sr.No. Name of Procedures Cost of Procedure USD
1 ICSI Evaluation Package 600-1000
2 Intracytoplasmic Sperm Injection (ICSI) 3500-6000
3 Intracytoplasmic Sperm Injection (ICSI) with Donor Egg 4500 – 7500
4 Intracytoplasmic Sperm Injection (ICSI) with Donor Sperm 4500-7500

Frequently Asked Questions and patient concerns:

1. What is ICSI fertility treatment?

A potential treatment for male infertility is intra cytoplasmic sperm injection (ICSI). In this process to ensure fertilization, the sperm is directly inserted into an egg inside a test-tube. ICSI treatment is a possible choice for a couple to conceive, especially when faced with male infertility problems.

2. Who should consider ICSI?

In the case of male factor infertility with irregular semen analysis, ICSI is considered totally appropriate. In order to increase their results, even though the treatment is not explicitly indicated, many patients prefer to undergo the ICSI procedure.

3. How successful is ICSI?

Through the ICSI process, conception has been achieved by many couples with challenging male factor infertility issues. Fertilization rates of 70 to 80 percent of all injected eggs are currently being reached, equal to normal sperm fertilization, and pregnancy rates are similar to those seen in couples without male factor infertility with IVF.

4. Are IVF and ICSI both different fertility treatments?

In ICSI, in a laboratory setup, the embryologist chooses a single high-quality sperm to be injected directly into the egg, while in IVF, fertilization takes place in a petri dish where many sperm are placed near a mature egg.

5. In ICSI, are all the eggs injected?

We’ll make every attempt to deliver as many eggs as possible if you decide to proceed with ICSI. It is vital for you to realize that sperm can only be injected to eggs that are mature. W whether an egg is mature or not, our IVF laboratory can easily tell. The chance of fertilization is very low in cases where the immature eggs are incubated with sperm. On average, we are able to inject 75 to 80 percent of the recovered eggs.

6. Are there discrepancies between ICSI and non-ICSI embryos in terms of embryo quality or conception rates?

When compared to non-ICSI embryos, there seems to be little difference in the overall embryo production obtained for ICSI embryos. Similarly, no disparity has been seen between ICSI embryos and non-ICSI embryos in pregnancy rates. While unproven, many infertility specialists claim that ICSI will improve the yield of embryos from a given number of recovered eggs, which has led to the increase in ICSI procedures.

7. What additional tests are required for ICSI?

Additional sperm tests are the most common, and a testicular biopsy (where a small piece of testicular tissue is removed) may be required if there is a problem with sperm production. To reassess hormone levels, blood tests may be needed.To determine the probability of passing on an inheritable disorder to some babies born as a result of treatment, certain couples may need to undergo genetic tests. This is especially important for men with weak sperm characteristics, since this can be caused by genetic abnormalities in some instances.

8. What are the advantages of ICSI treatment?

ICSI is a method that essentially addresses male infertility by directly integrating sperm cells into an egg. ICSI is the best remedy to the primary causes such as low sperm count, poor motility, and poor sperm structure, of male infertility. The advantages of ICSI extend beyond simply serving as a cure for male infertility, but even for someone who is paralyzed or has undergone a permanent vasectomy. For couples who have tried and failed with traditional IVF therapy, it is an alternative.

9. How many days rest required after ICSI Treatment?

It is possible to transfer the embryo within two to three days of fertilization or five days of fertilization. The egg will be in the blastocyst process for five days after fertilization. One ICSI cycle takes about four to six weeks to complete.

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