Published : 2022/10/08 at 10:00 pm

The head of the sperm should be attached to the outside of the egg before it may fertilise a woman’s egg. Once connected, the sperm pushes through the egg (cytoplasm) to the interior, where fertilisation occurs.

ICSI Fertility Process

Intracytoplasmic Sperm Injection (ICSI)

For a variety of reasons, the sperm occasionally cannot penetrate the outer layer. The sperm may not be able to swim or the egg’s outer layer may be thick or difficult to penetrate. In certain situations, intracytoplasmic sperm injection, often known as ICSI, can be used in conjunction with in vitro fertilisation (IVF) to assist in fertilising the egg. A single sperm is injected directly into the cytoplasm of the egg during ICSI.

ICSI Process step by step

The woman will first need to take fertility medicine to increase the creation of eggs in the ovaries, much like with regular IVF. The doctor will regularly monitor the eggs’ development during this period. When the egg is prepared for retrieval, the ICSI process is performed.

Step-1: Retrieval

Either the Man ejaculates into a cup and provides a sample of sperm, or the doctor have to remove the sperm surgically. There are numerous methods for getting the sperm out. Sometimes, the sperm retrieval procedure may be performed sooner and the doctor may freeze the sperm.

The woman’s ovaries will also be harvested for several eggs utilising an ultrasound probe and fine needle. Although this technique is not painful, it could cause slight bruising and soreness.

Step 2: Sperm injection into the egg

After being retrieved, a single sperm is extracted after washing the semen sample. A hollow, extremely thin needle is then used to inject this into an egg. The sperm does not have to swim through the cervical fluid because it is injected immediately. A sperm will take up to 24 hours to fertilize an egg and create an embryo.

Step 3: Monitoring the Embryo

For up to 6 days, the fertilised embryos are kept in a lab. Embryos will be monitored for signs of development and growth during this time. Not every fertilised embryo will be placed in the woman’s womb. So, selecting the healthiest and most viable embryos requires this stage.

Step 4: Transfer of Embryos

One or two embryos are chosen and transferred to the woman’s womb using an ultrasound-guided catheter once the embryo reaches a specific stage of development. This could occur two days or five days after fertilization.

Elective Single Embryo Transfer

One of the most common risks connected with IVF is multiple pregnancies. Many women choose to have single egg returned to the uterus in order to avoid this. The term “eSET” stands for “Elective Single Embryo Transfer.” In these types of cases, the Doctor will hold off until the embryo has developed to the blastocyst stage. If the IVF cycle is unsuccessful, extra high-quality embryos may be frozen and saved for later use.

From this point on, the process is same as normal pregnancy. The embryo must attach to the uterine walls in order to develop further. Two weeks after the fertilised egg has been transferred to the womb, a pregnancy test is typically indicated. It is significant to note that while IVF with ICSI has a higher rate of fertilisation than IVF without ICSI, but the success rate for both is same.

ICSI Risk

ICSI is a method that is generally considered to have low associated risks. But, ICSI does have some risks and drawbacks of its own, just like any other medical procedure. The male partner is not at risk from the operation after the sperm has been obtained. The only dangers are minimal and relate to the sperm retrieval techniques. ICSI risk factors include, among others:

Embryo damage: Not all fertilised eggs develop into healthy embryos. During the ICSI procedure, some eggs and embryos may sustain damage.

Multiple pregnancy: Couples who combine ICSI and IVF have a 30–35% higher risk of conceiving twins and a 5%–10% higher chance of conceiving triplets. The chances of various risk during pregnancy and childbirth, such as high blood pressure, gestational diabetes, low amniotic fluid levels, early labour, or the necessity for a caesarean section, increases when the women is carrying multiples.

Birth defects: With a normal pregnancy, there is a 1.5%–3% risk of a serious birth defect. ICSI treatment marginally increases the incidence of birth abnormalities, however they are still uncommon. Angelman syndrome, Beckwith-Wiedemann syndrome, sex chromosomal abnormalities, and hypospadias are a few congenital disorders linked to ICSI. A male offspring’s chance of experiencing reproductive problems also marginally rises. There is a chance that infertility could be passed genetically.

Many doctors do not advise using ICSI with every IVF round because of these added risks. It makes sense if ICSI is a must in order to become pregnant. In that situation, be sure to talk to your doctor about the benefits and drawbacks of using the technology. Nevertheless, if an IVF cycle can be completed successfully, why take a chance on something as minor as a birth defect?

The specific patient and their health state determine how well the surgery goes. Nevertheless, studies indicate that 25% of patients can conceive after just one ICSI procedure. It is important to view the technique as a way to mix the sperm and the egg, not as an assurance of pregnancy.

Is ICSI better than IVF

When there is no male infertility issue, research demonstrates that IVF is equally as effective as the ICSI process, in which sperm is directly put into an egg. In these circumstances, the cumulative live birth rates in Victoria for IVF and ICSI were comparable.

Two methods of egg fertilisation are available in assisted reproductive technology (ART): IVF (in-vitro fertilisation) and ICSI (intracytoplasmic sperm injection). Each egg in IVF is supplemented with thousands of sperm in the hopes that one will fertilise the egg. In ICSI, the embryologist chooses a single sperm that is injected into the egg using a microscope and highly technological equipment. The embryologist determines if the eggs have fertilised and grown into embryos a few days after IVF and ICSI.

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