What is the Procedure for Successful ICSI?

In cases where a man’s sperm is unable to fertilize an egg even with IVF, a specialized procedure called Intracytoplasmic Sperm Injection ICSI may be performed. This procedure helps increase the couple’s chances of conceiving. This procedure may be used in cases of male infertility caused by low sperm count, low motility, azoospermia, erectile issues or cases of infertility that have no identifiable cause.

What is a successful ICSI Procedure?

As with regular IVF, the woman will first need to take fertility medication to stimulate the production of eggs in the ovaries. During this time, the doctor will monitor the development of the eggs. The ICSI procedure is performed when the egg is ready to be retrieved.

Step 1: Retrieval

The man will have to produce a sperm sample ejaculating into a cup or the sperm will have to be surgically retrieved. There are a number of different ways the sperm may be retrieved. In some cases, the sperm retrieval procedure may be performed earlier and the sperm may be frozen.

Multiple eggs will also be harvested from the woman’s ovaries using a fine needle and ultrasound probe. This procedure is not painful but it may cause slight bruising and soreness.

Step 2: Injection of Sperm into Egg

Once retrieved the semen sample is washed and a single sperm is isolated. This is then injected into an egg with a very fine hollow needle. Since the sperm is injected directly, it bypasses the need to swim through the cervical fluid. It can take a sperm up to 24 hours to fertilize an egg and create an embryo.

Step 3: Monitoring the Embryo

The fertilized embryos are kept in a lab for up to 6 days. During this time they are monitored for signs of growth and development. Not all the fertilized embryos will be transferred to the woman’s uterus. Hence this step is essential to pick out the healthiest and most viable embryos.

Step 4: Transfer of Embryos

Once the embryo has reached a certain stage of development, one or two embryos are selected and transferred to the woman’s womb using an ultrasound-guided catheter. This may happen 2 days after fertilization or 5 days after fertilization.

Elective Single Embryo Transfer

Multiple pregnancies are one of the most common risks associated with IVF. To prevent this, many women choose to have a single egg transferred back to the uterus. This is known as Elective Single Embryo Transfer or eSET. In such cases, the doctor will wait until the embryo has reached a blastocyst stage. If you have extra good-quality embryos, they may be frozen and kept for later use in case the IVF cycle is unsuccessful.

From here on the procedure is the same as a normal pregnancy. The embryo must attach itself to the walls of the uterus and continue to develop. A pregnancy test is usually advised two weeks after the fertilized egg has been transferred to the womb. It is important to note that the fertilization rate of IVF with ICSI is much higher but the success rate of IVF with ICSI and IVF without ICSI is the same.