Intra-Cytoplasmic Sperm Injection (ICSI)

ICSI treatment stands for intra-cytoplasmic sperm injection. It is a gold standard technique used for overcoming severe male infertility, after repeated unsuccessful attempts with in vitro fertilization or egg freezing. The procedure involves the injection of a single, healthy sperm directly into the cytoplasm of the female egg so as to induce artificial fertilization and obtain the embryo. ICSI has proved to be the most successful form of IVF treatment as the procedure gives the doctors the power to choose the most viable sperm.

Why is ICSI Treatment done?

For fertilization to take place normally, the head of the sperm must attach to the ovum and penetrate through the outer layer so as to reach the cytoplasm, where the procedure actually takes place. However, in certain cases, the sperm is not able to push through the outer wall of the ovum owing to a plethora of reasons, one of the most common of which is male infertility.

Male infertility refers to the inability to impregnate a fertile female even after persistent efforts.

Azoospermia is a condition marked by no sperms in the semen.
Oligospermia is a condition marked by very low sperm count.
Teratozoospermia is marked by the production of sperms with structural abnormalities.
Asthenozoospermia which is marked by poor sperm mobility.
Retrograde ejaculation ejaculation is marked by the backward flow of the semen into the bladder instead of coming out of the penis.

ICSI may also be recommended for any of the following reasons:

The outer wall of the ovum, i.e. zona pellucida, is very thick and does not allow the sperm to penetrate on its own.
Previous failed attempts with IVF.
The thawed sperm is not very active (In case frozen sperms and oocytes are being used).
If PGD or preimplantation genetic screening is being done as natural fertilization can interfere with the results.

Sperm retrieval for ICSI:

Sperm retrieval is the most important step in the ICSI procedure which can be done in various ways depending upon the cause of infertility and its severity.

If a male has alleviated sperm count or mobility, the sample can be collected via normal ejaculation using penile vibratory stimulation (PVS) and Electro ejaculation (EEJ).
Microsurgical vasectomy reversal can be used to retrieve the sperm of males who have undergone a vasectomy in the past.
Needle aspiration or microsurgical sperm retrieval can be used for males who do not respond well to microsurgical vasectomy reversal.

Ovum retrieval for ICSI:

Before retrieving the ovum, it is very important to carry out ovarian stimulation for egg harvesting. This is done by administering certain hormones to facilitate the production of more eggs. The female is required to undergo regular tests and screenings to trace the progress of the procedure and to enable the doctors to take the necessary measures for optimizing egg development and numbers.

The egg is retrieved post 34 to 36 hours of administering the final injection. The female is sedated and a transvaginal ultrasound aspiration technique is used to carefully remove the eggs from the follicles, with the help of the suction device. The eggs, thus collected, are preserved in nutritive liquid and incubated to be used for fertilization.

ICSI procedure step by step

The matured egg is held with the help of a specialized pipette.
The healthy sperm is picked up using a hollow and delicate needle which is carefully injected through the outer wall of the egg, into the cytoplasm.
The needle is removed and the egg is monitored for evidence of fertilization.
Soon after the fertilization takes place, the embryo is placed inside the uterus of the female partner where it grows naturally.
Blood tests and ultrasounds are carried out from time to time to determine if the implantation was successful as well as to trace the progress of the pregnancy.

To know if ICSI is an option for you, consult the fertility experts at Medfemme Women’s Clinic.