ICSI Treatment

ICSI (Intracytoplasmic Sperm Injection) is special embryology laboratory procedure in which sperm is directly injected inside the oocyte for fertilization process.

Who needs ICSI?

• Male factor infertility – Very low sperm count, motility, morphology (OATS), Azoospermia (No sperms in semen – ICSI with testicular sperms)
• Non-male factor infertility
  • Failed and poor fertilization in previous cycles
  • Preimplantation genetic screening (PGS)
  • Fertilization after in vitro maturation (IVM)
  • Fertilization of cryopreserved oocytes
  • Frozen semen sample

How is ICSI carried out?

Sperm collection should be done on egg pick up day in IVF center only. But in case husband is not comfortable to give sample in center then he can bring sample from home within 45 minutes to 1 hour on normal body temperature. If husband is not able give sample or in cases of azoospermia (no sperms in semen), sperms can be directly retrieved through testes or sperm ducts. If husband cannot be available at the time of egg pick up then semen freezing can be done in advance.

The eggs are fertilized with sperms in laboratory and the fertilized egg forms the embryo. It is performed shortly after oocyte retrieval either by conventional IVF or by ICSI.

In conventional IVF fertilization, each oocyte is incubated with approximately 50,000 sperm and fertilization happens naturally.

For ICSI, one sperm is selected and directly injected into each oocyte. The oocyte is denuded from surrounding cumulus cells, stabilized by a micropipette, and injected with the sperm.

Advantages of ICSI  - Improves the pregnancy rate by choosing best sperms -

• In Poor DNA fragmentation
• Good results in frozen eggs and frozen sperms
• Better in cases of PGT a/m cases
• In case of history of vasectomy
• Advance maternal age

Disadvantages

• Embryo damage: Depending on expertise may happen
• Multiple pregnancy: Chances of twins or triplets increases
• Birth defects: There is a 1%-2% risk of a major birth defect with normal pregnancy. It is increased slightly with ICSI treatment, although its very rare.