Intracytoplasmic Sperm Injection (ICSI)

What is Intracytoplasmic Sperm Injection?

Intracytoplasmic sperm injection is a popular assisted reproductive technique in which doctors select the most potent and healthy sperm from the sample collected from the male partner and directly administered into the ovum of the mature female egg.

The technique has proved to be a boon for couples with severe male factor infertility where the sperm me not be healthy enough to penetrate through the cumulus mass and egg zona pellucida, to initiate fertilization.

Who needs Intracytoplasmic Sperm Injection:

Intracytoplasmic sperm injection is a gold standard technique used in the case of severe male factor infertility, linked to the quality and quantity of sperm. The most common conditions include:

• Azoospermia, marked by the absence of sperm in semen
• Oligospermia, marked by negligible sperm count
• Teratozoospermia, marked by structural anomalies in sperm
• Asthenozoospermia, marked by low sperm motility

Apart from these conditions, intracytoplasmic sperm injection me also be recommended if:

• The male is experiencing retrograde ejaculation
• The outer wall of the egg is abnormally thick making it difficult for the sperm to penetrate
• The couple has tried IVF without successful results
• In cases where fertility preservation was used to preserve the sperm. 

What are the steps involved in  Intracytoplasmic Sperm Injection?

Before initiating the intracytoplasmic sperm injection procedure doctors need to make sure that both the parents are healthy and qualify for it.

This is done by conducting a physical examination of the intended mother, evaluating the medical history of both partners and performing certain tests.

Once our expert makes sure that you both are eligible for the procedure, you will be briefed about the same. There are various steps involved, each playing a significant role in the procedure as a whole.

• Step I - Ovarian Stimulation: This step is also referred to as ovulation induction, and it involves the stimulation of the ovaries with the administration of certain medication, to enhance the production of eggs. The medicines are to be injected subcutaneously, as per the doctor's recommendation. This is to be done daily for around 2 weeks. During the ovarian stimulation stage, you will be closely monitored through periodic transvaginal ultrasounds, to assess the development and growth of eggs.
• Step II - Egg Retrieval: This step is initiated around 34 to 36 hours after you take your last injection. The procedure is carried out under IV sedation to make sure that you do not feel any pain or discomfort. Doctors use the transvaginal ultrasound aspiration technique, which involves the use of a thin needle to pierce through the follicular wall and retrieve eggs. The procedure may take anywhere between 20 to 30 minutes. These eggs are carefully preserved in a special incubator.
• Step III - Sperm Collection: This can be planned on the same day when the retrieval is done or you can schedule it at your convenience after consulting your doctor. The male partner is provided with a sterilized container to collect the sperm sample in a private room. In the case of severe male factor infertility, doctors may need to perform a small procedure to retrieve the sperm. This can be done either by percutaneous epididymal sperm aspiration technique (PESA) or testicular sperm extraction technique (TESE).
• Step IV - Fertilization: This step is the main point of difference between the standard IVF procedure and the ICSI procedure. In the case of IVF doctors place the healthy eggs and sperm together and let fertilization take place naturally, however in the case of intracytoplasmic sperm injection, the fertilization is forcefully induced by injecting the sperm directly into the ovum using a thin glass needle.
• Step V - Embryo Transfer: Once fertilization takes place the embryo is thoroughly assessed and transferred into the uterus of the intended mother, nearly 5 to 6 days following the retrieval, The implantation is done using transabdominal ultrasound. Doctors may recommend blood tests and ultrasound to assess the success of the procedure.
• Step VI - Pregnancy Test: The pregnancy test is to be performed after 12 to 14 days of embryo transfer. Once the pregnancy is confirmed, you need to go for an ultrasound to ensure there are no complications.

What are the benefits of Intracytoplasmic Sperm Injection?

Intracytoplasmic sperm injection is a modern form of assisted reproductive technique that was created as an improvement to conventional in vitro fertilization. The procedure is widely recommended for its noteworthy benefits that include:

• It can be used to help couples who are experiencing difficulties in conceiving due to unknown factors, i.e. idiopathic infertility.
• The chances of fertilization are higher as compared to other IVF techniques, as the sperm conveniently reaches the ovum, without having to penetrate through the cumulus mass and egg zona pellucida. 
• The procedure can significantly help to enhance the chances of conception in couples who are not able to do so naturally due to male factor infertility.
• The technique can also be used for couples who have undergone sterilization procedures for birth control. 
• It gives the couples control over timing allowing them to decide when they want to have a baby without any pressure.