What is Intracytoplasmic sperm injection (ICSI?
Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technology (ART) used to treat sperm-related infertility problems. ICSI is used to enhance the fertilization phase of in vitro fertilization (IVF) by injecting a single sperm into a mature egg. The fertilized egg is then placed in a woman’s uterus or fallopian tube.
For whom ICSI is advised?
Indications for ICSI may include the following…
- Where a previous IVF cycle has resulted in failed fertilization
- If the number of sperm in the ejaculate is very low (Oligospermia)
- If the motility of the sperm is poor. (Asthenospermia)
- If the morphology (shape) of the sperm is poor. (Teratospermia)
- If there are no sperm in the ejaculate (Azoospermia), and sperm therefore have to be surgically retrieved from the epidydimis (MESA – microsurgical epididymal sperm aspiration) or testis (TESA – Testicular sperm aspiration)
- If there are antisperm antibodies present.
- If there are frozen sperm only available, with limited counts and motility. Sperm may be banked and frozen in cases where the sperm counts are very low, in men who need the sperm surgically retrieved (TESA, MESA) or in men who have banked sperm before chemotherapy for cancer.
Read : List of Top 10 IVF Specialist in India 2023
How is ICSI done?
ICSI is part of the whole IVF (In Vitro Fertilization) process. During a normal menstrual cycle, only 1 egg is usually recruited to mature in a capsule of fluid called a follicle. The maturation time of the egg inside the follicle is usually 10-14 days. Most follicles measure about 16 – 20 mm when the egg is mature. At this time during natural ovulation, the follicle ruptures and the egg is released. During IVF, fertility drugs are used to stimulate the ovaries and recruit a bunch of eggs. So instead of just one follicle maturing, a whole number of follicles are stimulated to grow. These follicles are monitored by ultrasound, and when they reach maturity the eggs are surgically retrieved. For retrieval, a fine needle is passed through the vagina and into the ovaries, where eggs are aspirated from the follicles. The eggs are cultured for about 3 to 5 hours for final maturation in the laboratory. Concurrently the sperm is prepared. Sperm may be collected from an ejaculated specimen of semen, or prepared from a previously frozen surgically retrieved specimen.
The eggs are then stripped of the cumulus cells (which are the sunburst array of cells around the egg) The cells are removed to assess the maturity of the egg, to better visualize the egg during the ICSI process, and to prevent the inadvertent injection of DNA from the cumulus cells into the egg. The stripping is done with an enzyme called hyaluronidase, which is normally found in the sperm heads. In normal fertilization it is this enzyme that allows the sperm to digest their way through the cumulus cells to the egg.
Read : Frozen Embryo Transfer Program in India
A tiny collection of sperm is placed in a viscous solution called “sperm catch” – and this slows down the motility of the sperm making them more easily assessed and caught. A healthy sperm is identified and then immobilized by striking the tail with a tiny glass needle called the injection pipette. The sperm is then aspirated tail-first into the same glass pipette. Using a high-powered microscope with sophisticated star wars type manipulation equipment, the egg is located and held in position by a holding pipette.
The injection pipette is inserted into the egg thereby tenting the membrane – and gentle suction applied until the elastic membrane is broken. Once the membrane is broken the sperm can be deposited into the egg and then the injection pipette is removed.
Once the pipette is removed the egg will resume its normal shape and is then put into a specialized culture medium in an incubator. It is then assessed for fertilization 18 hours after the injection.
BENEFITS OF ICSI
ICSI is only suitable for attempting to achieve fertilization where the sperm of the male partner are unable of achieving acceptable fertilization rates using routine IVF. ICSI has been shown to achieve fertilization rates of about 70%. (“Normal” sperm will fertilize about 70% of mature eggs in normal IVF).
ICSI has resulted in pregnancy rates, which are similar to IVF success rates. These rates depend to a large extent on:
- Age of the woman
- Her infertility status and cause.
- Number of embryos replaced.
Men whose sperm are unable to achieve adequate fertilization rates in IVF now have the opportunity to father their own children with the use of ICSI, which would not have been possible any other way. There is evidence that the incidence of abnormalities in fetuses and children resulting from ICSI procedures is no greater than in the normal population,
Read : Embryo Freezing Program in India – Costs, Benefits and Risks
Fertilization and pregnancy rates with ICSI
Fertilization rates for ICSI in most good IVF programs are about 60-85% of eggs injected.
Pregnancy rates for in vitro fertilization procedures with ICSI have been shown in some studies to be higher than for IVF without ICSI. This is because in many of the cases needing ICSI the female is relatively young and fertile (good egg quantity and quality) as compared to some of the women having IVF for reasons other than male factor infertility. Another way to say this is – average egg quantity and quality is usually better in ICSI cases (male factor cases) because it is less likely that there is a problem with the eggs – as compared to cases with unexplained infertility in which there is more probability of a somewhat reduced egg quantity and quality (on the average, since some women in this group have egg related issues).
For More Information Call on : +91 7387617343 Email : [email protected] Direct Contact on Whatsapp : +91 7387617343 [contact-form-7 id=”536″ title=”Contact form 1″]KEYWORDS : IVF Treatment in India, IVF Treatment Cost in India 2024, ICSI Treatment in India, ICSI Treatment cost in India 2024, icsi procedure cost in india, icsi treatment cost, icsi treatment success rate, icsi success rate in india, icsi procedure step by step, icsi cost in indira ivf, icsi treatment means, icsi treatment cost in mumbai, fertility specialist in delhi, iui cost in aiims delhi, fertility clinic in delhi, ivf centre delhi, iui centre in delhi