What is ICSI Treatment?

Introduction

Worldwide, millions of couples are affected by infertility. Male infertility is responsible for almost half of all cases of infertility. Intracytoplasmic sperm Injection is one of the most successful and advanced treatments for male infertility. This technique has revolutionized the fertility care industry by giving hope to couples with limited options.

What is ICSI Treatment?

ICSI stands for Intracytoplasmic Sperm Injection. This is a form of IVF where a single-sperm is directly injected into an egg. This method is particularly useful when there is difficulty with the sperms’ ability to penetrate the egg or fertilize it on their own.

ICSI injects one sperm into one egg using microscopical instruments. This is different from conventional IVF where thousands of sperms are placed around an egg in a lab dish and allowed to naturally fertilize. This method increases the chances of fertilization for couples who have severe infertility, or failed IVF.

Who needs ICSI?

ICSI is recommended most often for:

• Low Sperm Count (Oligospermia) :- When sperm counts are too low to allow for IVF or natural fertilization.
• Asthenozoospermia :- When the sperm is unable to swim well enough to reach the egg and fertilize it.
• Sperm with abnormal shape (Teratozoospermia) :- When sperms’ shape prevents them from entering the egg.
• Azoospermia Obstructive :- Sperm produced, but sperm cannot be expelled due to obstruction in the reproductive tract.
• Previous failed cycles of IVF :- Particularly when fertilization has not occurred despite the use of healthy eggs and sperm.
• Surgical sperm extraction :- When sperm is removed directly from the testes.
• Use frozen sperm and eggs :- ICSI improves fertilization with cryopreserved reproductive material.
• Unexplained Infertility :- When standard treatments fail and no cause for infertility can be found.

How is ICSI performed?

ICSI is part of the IVF cycle, and includes several steps.

1. Ovarian Stimulation :- For 10-14 days, the female partner receives hormone injections to stimulate her ovaries into producing multiple eggs. Blood tests and ultrasonic scans are used to monitor the development.

2. Retrieval of Eggs :- The eggs are then removed from the ovaries with a fine needle under ultrasound guidance. The procedure is performed under mild anesthesia or sedation.

3. Sperm Collection :- If the male partner is unable to produce sperm, sperm can be collected by ejaculation.

4. Sperm Selection :- The best sperm is selected under a powerful magnifying glass.

5. Sperm Injection (ICSI) :- A microneedle is used to inject a single sperm directly into each egg. A trained embryologist uses advanced micromanipulation instruments to perform this process.

6. Fertilization & Embryo Culture :- In the laboratory, the eggs are placed in a culture medium. They are examined for signs of fertilisation after 16 to 18 hour. The fertilized egg (now called an embryo) is cultured for several more days.

7. Embryo Transfer :- Three to five days after fertilization, the best quality embryos are transferred into a woman’s uterus. This procedure does not involve anesthesia and is completely painless.

8. Pregnancy Test :- A blood test will be done 12-14 days after the transfer of embryos to determine if a pregnancy has occurred.

ICSI Treatment Benefits

ICSI has several benefits, especially in cases of male infertility.

1. ICSI can help overcome sperm problems :- Fertilization is possible even with low sperm counts or poor motility.
2. Higher Fertilization rates :- In certain cases, ICSI can significantly increase the chances of a successful fertilization compared with standard IVF.
3. Allows Fertilization with Limited Sperm :- The ICSI technique allows for fertilization using very few sperm or sperm that has been surgically obtained.
4. Effective after Failed IVF :- This method is often successful for couples who have not been able to achieve fertilization by traditional IVF.
5. ICSI is more effective with frozen sperm or eggs :- Cryopreserved reproductive material often responds better to ICSI.

Risks and considerations

ICSI has its own risks. These include:

1. Egg Damage :- The egg may be damaged during the injection and not fertilized.
2. Fertilization Failure :- Some eggs, although rare, may not fertilise after ICSI.
3. Genetic Risks :- Some studies indicate a slight increase in the risk of genetic disorders. This is especially true if male infertility has genetic causes. In such cases, genetic counseling is recommended.
4. Cost :- ICSI Cost increases the cost of IVF. ICSI in India can cost anywhere between Rs 1,00,000 and Rs 2,50,000, depending on clinic location.
5. Multiple Pregnancy Risk :- There is a greater chance of having twins or triplets if more than one embryo has been transferred. These are both associated with increased pregnancy risks.

Conclusion

ICSI Treatment has brought hope to thousands couples who were struggling with male infertility. It is a very advanced fertility technique that offers high success rates in fertilization, even for complex cases. It comes with higher costs and some risks, but for many couples ICSI is the key to unlocking their journey towards parents