ICSI stands for intracytoplasmic sperm injection technique. This is a type of fertility treatment against male infertility issues. In the ICSI treatment, one single healthy sperm from the person is selected individually from the semen sample. Doctors will consider advanced micromanipulation techniques in the process. They will inject the sperm into the cytoplasm of the female ovum. After fertilization of the egg, the doctors will transfer it into the uterus for further development.
Indications for ICSI treatment
Doctors will recommend ICSI procedures for couples with male infertility issues. These issues include poor quality of sperm, low sperm count, etc. For couples, it is also a treatment of choice when conventional IVF therapy fails. The major reasons why ICSI is needed are as follows.
- Poor sperm motility or morphology
- If previous attempts of ICSI fail or are unsuccessful.
- If doctors retrieve the sperm from the male surgically through procedures like TESA or PESA.
- When doctors choose to use frozen sperm from men with a history of chemotherapy or radiotherapy.
ICSI treatment will happen concurrently with the IVF procedure. Doctors will assess the partner thoroughly to determine the most suitable fertility treatment.
Other reasons why ICSI is needed
Some reasons why ICSI is needed to conceive the baby may project into multiple factors and not male infertility alone. At times, doctors will retrieve a good number of eggs from the female, and the sperm count will also be good, but fertilization won’t occur. So, doctors will try ICSI after the IVF procedure. If doctors are using frozen sperm after thawing them, then they will try ICSI treatment, as the sperm won’t be active.
At times, if they use frozen eggs, then the eggshell will be very hard, and it will complicate the fertilization process. In such instances, IVF with ICSI can help overcome the hurdle. In in-vitro maturation, doctors retrieve eggs from the ovaries before they mature and perform maturation in the lab. Then, in such situations, they will consider ICSI treatment.
Process of Intracytoplasmic Sperm Injection (ICSI) procedure
The ICSI treatment is a procedure that incurs four steps, and these steps are as follows.
- Ovarian Stimulation: Similar to the IVF process, the female should undergo hormone therapy to stimulate the ovaries to produce more eggs. Doctors will monitor the growth of the ovarian follicles during this process.
- Egg Retrieval: Once the follicles have grown to an adequate size, the doctor will perform the egg retrieval process before ovulation. Doctors will retrieve the eggs using an ultrasound probe inserted into the vagina, putting the mother under general anesthesia. Doctors will harvest multiple eggs. The male is recommended to donate the sperm on the same day. In some situations, doctors may perform sperm retrieval through PESA or TESA.
- Fertilization process: The doctors will screen the eggs they collect. Then, they will inject each egg with sperm to favor fertilization. They will culture the eggs in the lab. Sometimes, they perform assisted laser hatching if the situation demands.
- Embryo transfer: Doctors will choose the most viable embryo and deposit it into the uterus using a thin catheter during ICSI treatment. They will freeze the additional embryos to transfer in future cycles without the need for ovarian stimulation.
What is the success rate of the ICSI procedure for the first time?
ICSI is a very successful procedure that helps fertilize the egg. However, its success rate depends on various factors like maternal age, cause of infertility, etc.
ICSI treatment is a part of the IVF process. The females are recommended with ovarian stimulation drugs to boost the success rate of this procedure to 50 to 80%. About 25% of the patients can conceive with only one attempt at the ICSI procedure. However, the success rate of ICSI treatment may vary from one person to another based on age, health condition, and lifestyle factors.