ICSI

“ICSI a successful treatment for sperm fertility and motility”

Before conceiving, a man’s sperm need to fertilize with a woman’s egg, where the head of the sperm must attach the egg in the outer layer, allowing the sperm to push inside the egg (cytoplasm) for fertilization. In a few cases, sperm fails to penetrate due to a variety of reasons leaving the couple infertile.

In the fertility center, the couples are given treatments of IUI, IVF, ICSI depending on the infertility test of the patients. There are circumstances where an individualized approach gives the highest chance of success while factors such as medical history, age, and response to the previous cycle may suggest a split ICSI. A fertility specialist before suggesting IUI, IVF and ICSI treatment shall thoroughly examine the pre-test reports.

ICSI process is suggested when the male partner has sperms with reduced motility (asthenospermia), low concentrations of sperms in semen (oligospermia), excessive presence of abnormally shaped sperm (teratozoospermia/ teratospermia) or the other rooted issues of sperm penetration. Intracytoplasmic. Sperm Injection (ICSI) fertility treatment is the most common and result-oriented cure for couples caught in the turmoil of infertility. It can also be an effective means of treatment for anti-sperm antibodies in the semen.

Overview of Intracytoplasmic Sperm Injection (ICSI)

Performed as the only component of IVF- ICSI treatment, the procedure involves injecting single sperm directly into the cytoplasm of a mature egg (oocyte) by using a needle under microscopic visualization. The technique was developed to gain success over infertility and to give hope to the partners who constantly faced failure in the previous IVF cycle. The only aim of the ICSI fertilization is to overcome barriers to fertilization and allow the couple to achieve fertilized embryo.

What is the ICSI procedure?

The ICSI procedure is no ordinary process. For successful fertility, the ICSI process has to be followed properly and under the guidance of a fertility expert. Beneath are the ICSI procedure step by step:

1. Ovarian Stimulation

   • With medication, the ovaries are stimulated to encourage the growth of follicles containing eggs.
   • The ovaries are examined via ultrasound or blood tests to check the quantity and size of the follicles.
   • To loosen the egg from the follicle wall, a Human Chorionic Gonadotrophin (hCG) is triggered.

2. Egg Retrieval

   • Under the ultrasound guidance, egg retrieval is performed within 35-38 hours.

3. Sperm Selection

   • For insemination, motile sperm are selected. Sperms containing Hyaluronan (HA) which are likely to intact the DNA are chosen for the ICSI procedure.

4. Egg Assessment

   • To inspect the egg maturity, the cumulus cell surrounding the eggs are gently removed.

5. Insemination

   • In this ICSI process, a single sperm is directly injected into a mature egg.

6. Fertilization

   • After insemination, the composition is then placed to the incubator for further examination for 16-18 hours.

7. Culture

   • For growth, fertilization is then placed in a lab for 2-5 days.

8. Embryo Transfer

   • The selected embryo is transferred into a transfer catheter to get it released to the uterus via the cervix. On completion of the transfer, the patients will be asked to confine the daily activities for nearly 24 hours. While the pregnancy blood test shall be taken only after 14 days of the transfer.

9. Vitrification

   • The good quality embryos are stored for the later stage, in case the first cycle turns out to be unsuccessful.

Split ICSI Method of Pregnancy

There are two ways to get the eggs fertilized; IVF-ICSI or ICSI-IUI. These methods are recommended to the patients only when a single fertility treatment brings no positive result.

• IVF-ICSI treatment

  It involves the use of fertility drugs, to produce quality eggs and to stimulate the ovaries which are retrieved in the laboratory. The sperms and eggs are kept together for the fertilization process. Later the good quality sperm are transplanted in the uterus for ICSI pregnancy.

• IUI-ICSI treatment

  It involves the inserting of partners sperm in the uterus during the time of ovulation to fertilize for pregnancy. 

Men though produce sperm, may fail to produce high-quality sperm which may be further retrieved to testicular sperm extraction (TESE) ICSI for more refined results. Sperm retrieved through TESE require the use of ICSI, which is also used in the situation of retrograde ejaculation.

Situations where ICSI are recommended

ICSI treatment is recommended to that pair who are having to deal with male infertility factors such as:

• The male partner is incapable of producing quality and greater quantity sperm for artificial insemination (IUI) or IVF (also known as oligospermia).
• Abnormal shaped sperm (also known as teratozoospermia).
• Poor movement of sperm (also known as asthenozoospermia).
• Difficulty in attaching sperm with the egg.
• Blockage in the sperm reproductive tract preventing the sperm from fertilization.
• Failure in IVF and IUI cycle.
• A couple suffering from unexplained infertility.
• Using previously frozen eggs or in vitro matured eggs. 

Risk associated with ICSI male infertility treatment

The ICSI procedure involves no additional risk. In a normal pregnancy, the birth defect such as miscarriage lies in between 1.5 to 3 percent while in the case of ICSI treatment, birth defects are slightly higher and are faced by 1 out of 10 pairs. 

Few birth defects are also likely to incur during ICSI-IVF or ICSI-IUI. This especially arises due to chromosome abnormalities, Angelman syndrome, and hypospadias.

How much does ICSI treatment cost in Nepal?

ICSI cost varies and depends on the infertility test reports of the patient. Vatsalya is offering ICSI treatment in Nepal at affordable cost. This infertility center has the best ICSI doctor to identify unexplained infertility and cure them with advanced options. The success rate of taking the baby home using ICSI in Nepal in comparison to any other developed country is high. More ICSI treatment in Nepal presents the benefit of using your partner’s sperm to conceive, therefore you get your own biological child. To know more about ICSI Nepal, contact us!