ICSI- An Introduction
The head of the sperm must attach to the outside of the egg before a man’s sperm can fertilize a woman’s egg. This sperm then pushes through the outer layer to the inside of the egg for the fertilization to take place.
However, sometimes the sperm is unable to penetrate the outer layer, for various reasons like an egg’s thick outer layer inability of the sperm to swim. maybe unable to swim.
ICSI procedure is intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly into the cytoplasm of the egg when done along with in vitro fertilization (IVF) can help fertilize the egg in such cases?
ICSI is an assisted reproductive technology (ART) that is used to treat male factor infertility problems.
About ICSI Treatment
Intracytoplasmic sperm injection, or ICSI, means injecting alone live sperm directly into the center of a human egg or Cytoplasm.
Developed to help couples with severe male factor infertility or those who have failed to fertilize in a previous in vitro fertilization (IVF) attempt, ICSI withstands many of the obstacles to fertilization allowing the couples to obtain fertilized embryos successfully.
Reasons to consider ICSI
Severe male factor infertility with poor semen analysis where little or no sperm are ejaculated in the semen makes ICSI a necessity.
Reasons for ICSI May include:
- Prior poor fertilization with IVF
- Inconsistent sperm counts
- Unexplained infertility
- The male partner produces extremely few sperm for artificial insemination (IUI or IVF).
- Sperm not moving in a natural fashion.
- The sperm has trouble attaching to the egg.
- A blockage in the male reproductive tract
- Lack of fertilization of the eggs by traditional IVF, regardless of the condition of the sperm.
- Use of In-vitro matured eggs or previously frozen eggs
ICSI procedure is chosen by many patients to maximize their success rate even when the procedure is not apparently suggested.
Patients with abnormalities in any sperm test results should seriously consider ICSI. Dr. Shivani Bhutani, a widely acclaimed fertility specialist says that ICSI is also recommended if the male partner has had a vasectomy reversal, regardless of the sperm quality because the presence of sperm antibodies may affect fertilization in these cases.
The couples wishing to test the embryo for certain genetic problems also sometimes opt for ICSI as the procedure uses only one sperm for each egg and there is absolutely no chance of the genetic test being contaminated by other sperm.
Intracytoplasmic Sperm Injection ICSI Procedure
The sperm are surgically removed from a testicle through a small incision in case they cannot be collected by masturbation.
This technique is brought into use for cases where there is a blockage preventing the sperm from being ejaculated or there is a problem with sperm development.
Genetic problems that could affect the offspring of the men with little or no sperm in their semen genetic testing may be recommended before ICSI is started.
Ovarian stimulation with fertility medications is given to the female partner to initiate the development of several mature eggs, which are then aspirated through the vagina using vaginal ultrasound, and incubated under specific conditions in the embryology laboratory.
The semen sample is prepared by spinning the sperm cells through a special medium to separate live sperm from the dead sperm.
The single live sperm is then picked by the embryologist carefully in a glass needle and injected directly into the egg.
Eggs are checked for fertilization to see if they’ve been fertilized, after culturing them in the lab overnight.
The eggs that have been successfully fertilized after the incubation or have had 3 to 5 days to further develop are carefully chosen and one or more of them are placed in the uterus with help of a catheter that is inserted through the cervix.
The doctor recommends the number of embryos to be transferred, based on the patient’s age and other parameters. The other embryos may be recommended to be frozen for future use.
In ICSI an effort is made to inject as many eggs as possible. However, only eggs that are mature can be injected with sperm.
For the immature eggs that are incubated with sperm, the probability of fertilization is very low. On average 75 percent to 80 percent of the recovered eggs are able to be injected.
Read More:-The Difference Between IVF and ICSI
What To Expect After IVF Treatment
The whole procedure for in vitro fertilization (IVF) can be emotionally and physically demanding of the mother, requiring regular blood tests, daily shots, and periodic monitoring by the doctor.
However, done on an outpatient basis, these procedures require only a brief recovery time. Strenuous activities may need to be avoided for the rest of the day.
Success Rate of ICSI
Many couples with difficult male factor infertility problems achieve a good success rate with ICSI. Around 50% to 80% of eggs are fertilized during ICSI which is equivalent to fertilization with normal sperm, are currently being achieved, and pregnancy rates are comparable to those seen with IVF in couples with no male factor infertility. In ordinary language, on average, eight out of every 10 eggs are fertilized normally with ICSI.
Risks associated with ICSI
Most of the risks related to ICSI are the same as for in vitro fertilization. However, there are a few problems that may occur during or after the ICSI procedure like a small number of eggs, usually less than 5% being damaged or not growing into an embryo even after it is injected with sperm. The embryo may stop growing too sometimes.
Superovulation with hormone treatment can sometimes cause severe ovarian hyperstimulation syndrome (OHSS). But this risk is minimized by the doctor’s close monitoring of the patient’s ovaries and hormone levels during the treatment.
For the woman who gets pregnant naturally, there is always a 1.5% to 3% chance of the baby having a major birth defect. The overall risk of having a baby with a chromosomal abnormality associated with ICSI is similar to IVF but slightly higher than in natural conception.
The following problems can be attributed to sex chromosome abnormalities:
- Increased chance of miscarriage
- Heart problems for affected infants requiring surgery
- Chances of behavior or learning disabilities
- Increased risk of infertility in the child during their adulthood
One thing worth mentioning here is that the higher risk of birth defects may actually be caused by infertility and not the infertility treatments.
However, the chances of a chromosomal abnormality like Down’s syndrome are not increased with ICSI but in fact, increase with maternal age.
Once the fertilization takes place, the chance of multiple pregnancies is the same as with IVF with or without ICSI. There is also no difference in the overall embryo quality or pregnancy rates achieved with ICSI embryos as compared to non-ICSI embryos.
Highly effective treatment for sperm-related infertility, ICSI may have genetic risks, which are more likely due to infertility than the procedure.
Couples who fear chromosomal problems can seek genetic counseling before the treatment to be aware of their chance of having a child with birth defects. Do talk to the doctor about testing the embryo before transferring it to the mother.
With all the discussed risks and success rates, ICSI is proving to be a boon for couples especially with male factor infertility who wish to have children.
You may consult Dr. Shivani Bhutani at Eva Hospital to know more about the treatment plan based on your age, problem, and other factors. Remember a consultation with the Doctor is the first step towards achieving your dream of having a baby.
Find the best IVF center in Punjab where most fertility centers Dr. Shivani Bhutani offers infertility treatment for both males and females.