About Intracytoplasmic Sperm Injection (ICSI)

This is a specialised type of assisted reproductive technology procedure known as Intracytoplasmic sperm injection (ICSI). During the procedure, a sperm is placed into a woman's egg with a needle in a clinical or a lab setting. A sperm cell is directly injected into the egg or oocyte’s cytoplasm to develop an embryo or a fertilised egg. The procedure is a type of IVF.

Usually, doctors use the ICSI treatment along with IVF and the next day, the doctor checks to see if the egg is fertilised. The fertilised eggs are observed carefully as they develop over the following days until they become embryos with multiple cells. These embryos are then placed into the woman's uterus by the doctor.

Most embryo transfers are now Frozen Embryo Transfers. This means that the embryos can be re-frozen and later thawed before transfer. The step enables more control over the timeline and can lead to higher success rates than a direct embryo transfer. This way, aspiring parents can freeze and store any remaining best-quality embryos for future use and sibling journeys.

When Is ICSI performed?

Intracytoplasmic sperm injection is the most common and successful treatment for male infertility. ICSI is recommended in the following cases when:

  • Men have an extremely poor sperm count
  • Men are experiencing issues with sperm motility (sperm movement)
  • Men are facing problems with sperm development
  • Men have blockages that prevent sperm from being ejaculated, like after a vasectomy
  • Couples are aiming to increase the number of high-quality embryos obtained from a single egg retrieval

ICSI Process

When in vitro fertilisation (IVF) is used with intracytoplasmic sperm injection, the procedure allows otherwise sterile couples to become parents. ICSI treatment follows these steps:

  • Ovarian Stimulation:

    Medications are used to stimulate the ovaries for about 8 to 14 days to produce many mature eggs, increasing the chances of success.

  • Egg Retrieval:

    A doctor performs the procedure to collect eggs from the ovaries. The eggs are combined with the collected sperm for fertilisation.

  • Fertilisation:

    The embryologist injects the best quality sperm into each mature egg under a microscope.

  • Embryo Development:

    After fertilisation, embryos are monitored and allowed to develop for 3 to 5 days , aiming for high-quality embryos.

  • Embryo Transfer:

    The selected embryos are transferred into the woman's uterus, a simple procedure lasting about 5 minutes.

  • Pregnancy Test:

    Two weeks after the embryo transfer, a pregnancy test is done to check for pregnancy.

 

Benefits of ICSI Treatment

The primary advantage of the ART treatment like intracytoplasmic sperm injection during IVF (IVF ICSI) is an enhanced fertilisation rate, which can increase the number of fertilised eggs available for transfer or freezing. For couples struggling with male factor infertility, ICSI treatment can boost your chances for a successful fertilisation under standard insemination such as IUI. ICSI is effective for those looking to increase their high-quality embryos created from one egg retrieval. Men who don’t have issues with sperm development, sperm count, or sperm motility can still benefit from ICSI. Also, couples with failed previous IVF attempts may benefit from ICSI treatment. Additionally, couples who want to test for certain genetic problems often make good candidates for ICSI treatment.

How do you prepare for ICSI Treatment

Before ICSI treatment can begin, the fertility team collects the sperm and eggs. The egg retrieval process entails ovulation induction, where medication injections stimulate the ovaries, which results in mature eggs. At this stage, Transvaginal ultrasound technology is used to guide a needle into the ovaries to collect the eggs, with mild anaesthesia to ensure that the patient is comfortable. Also, the sperm collected is analysed for mobility, volume, and quality. In certain cases, procedures like microscopic testicular sperm extraction or electroejaculation may be necessary, and the sperm can be frozen and stored for future use in IVF.

How much does ICSI cost?

The price of ICSI fertility treatment typically starts at Rs 1,50,000, but it may vary depending on the fertility hospital you choose. In general, ICSI treatment in tier I cities is more expensive than in tier II and III cities for infertility treatment.

 

Frequently Asked Questions

1. How does ICSI help you with male infertility?

ICSI intracytoplasmic sperm injection is designed to address male infertility issues. It involves injecting a sperm directly into an egg, increasing the chances of successful fertilisation. If you have reduced sperm motility, low sperm count, or abnormal sperm morphology, ICSI fertility can significantly improve the likelihood of achieving pregnancy.

2. Is ICSI a suitable option for you if previous IVF attempts failed?

Yes, if previous IVF attempts did not result in successful fertilisation, ICSI IVF can be an effective alternative. By directly injecting a sperm into the egg, ICSI infertility treatment overcomes certain barriers encountered in standard IVF, providing you with a better chance of achieving pregnancy.

3. What can you expect during the ICSI procedure?

During the ICSI infertility treatment, you can expect a process similar to IVF, including ovarian stimulation, egg retrieval, and embryo transfer. However, in ICSI, an embryologist will carefully select a healthy sperm and inject it directly into each mature egg. Your fertility specialist will guide you through the entire process and explain any specific instructions or considerations relevant to your unique case.