Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic Sperm Injection (ICSI)

ICSI (Intra Cytoplasmic Sperm Injection)

In simple words, ICSI is a procedure that involves collecting million or more sperms to inseminate into a single egg for fertilization. However in Intra Cytoplasmic Sperm Injection (ICSI), a single sperm is injected into a single egg with the help of an instrument called the micromanipulator. Infertile couples with severe male factor infertility (poor sperm count, motility, or morphology) can restore their hopes of parenthood with Intra Cytoplasmic Sperm Injection. Now, men with the problem azoospermia or with no sperm in their ejaculate, can also father a biological child. ICSI is a safe, high-tech yet simple procedure that has good success rates all across the world.

Indications

  • Men with severe male factor infertility
  • Couples who do not want donor sperm insemination
  • Men who have sperm concentrations of less than 15-20 million per ml or
  • Sperm motility less than 35%, or
  • Very poor sperm morphology
  • Couples having IVF who have had a previous cycle with no fertilization, or
  • Women who face a low rate of fertilization (low percentage of natural fertilization of mature eggs)
  • All couples having IVF who have a very low yield of eggs at the egg retrieval (In this scenario, ICSI is beneficial for better success rates than with conventional insemination of the eggs.)

Procedure

The woman goes through a typical ovarian stimulation protocol during which the Doctor prescribes fertility drugs to support the procedure. These drugs support the production of multiple eggs. The embryologist surgically extracts these eggs (this phase is called oocyte retrieval).
For ICSI, the Doctor can extract the sperms from the ejaculate. If it is not possible to obtain sperms by this method, Doctors choose to perform a small surgical procedure to recover sperms from the testes. Usually a local or general anaesthesia is ideal for these procedures.

  • Micro Epididymal Sperm Aspiration (MESA) is a delicate surgical technique that involves using the microscope to aspirate sperm from the epididymal region.
  • Percutaneous Epididymal Sperm Aspiration (PESA) is a technique that involves extracting the sperm from the epididymis using a small needle and a local anaesthetic.
  • Testicular Sperm Biopsy (TESE) is a procedure that involves extracting a small biopsy of testicular tissue under anaesthesia. When there is no scope of obtaining sperm using MESA or PESA, TESE is usually the last option.

Sperm obtained by ejaculation, or through MESA, PESA, TESE must be processed well before the ICSI procedure is carried out. The selected sperm is then injected into the mature eggs retrieved from the woman, checked for fertilization, allowed to grow in the lab for about 72 hours and after that, selected embryos are transferred into the uterus. Sperms may also be retrieved ahead of time and frozen for future use.

Fertilization and pregnancy rate with ICSI

Generally, fertilization rates and pregnancy rates are higher in ICSI procedure compared to the conventional IVF procedures. Pregnancy and delivery should proceed normally if the female partner follows the guidance of the physician that she is consulting. There are no complications in terms of abortions, congenital abnormalities or pregnancy complications resulting because of the ICSI procedure.
This is a brief overview of ICSI procedure. If you have any further queries, please reach us at info@milann.co.in or to schedule an appointment with one of our doctors, click here. We would be happy to be of assistance.

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