How ICSI can help in infertility?

May 25, 2022
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Infertility causes and the issues associated with it are increasing day by day due to the stressful and hectic lifestyle of young couples all over the globe, that is obviously bad for the reproductive organs of both men and women. Thanks to the recent advancement in medical science means, there are effective ways to achieve pregnancy despite infertility. IVF is in vitro fertilization is the most widely used assisted reproductive technology which has a high success rate. There are many other assisted reproductive technology used to achieve pregnancy in case of infertility being used in the current era.

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What is ICSI treatment?

ICSI stands for intracytoplasmic sperm injection. ICSI is a specialized form of In vitro fertilization (IVF) that is primarily used for the treatment of severe cases of male-factor infertility. It is a procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. Fertilization occurs when the single sperm enters into the centre of the egg. In this technique a tiny needle called a micropipette is used to inject the sperm into the centre of the egg. The fertilized egg better known as an embryo is then grown in a laboratory for 1 to 5 days before it is transferred to the woman's uterus.

When is ICSI recommended?

ICSI is mainly used in case of male infertility. There are different types of male infertility that includes -

  • Impaired motility or moving ability of the sperm
  • Low sperm count
  • Absence of sperm in the ejaculate
  • Abnormal morphology of the sperm or abnormal shape of the sperm

There are a few rare cases in which ICSI can be highly helpful.  In such cases where IFV and IUI are not effective enough to achieve pregnancy, ICSI is recommended. The routine procedure of IVF involves the production of the embryo through the mixing of the retrieved eggs with a large quantity of sperm and incubation in culture. Therefore, the success of the process is dependent on the availability of adequate healthy and viable sperm for achieving fertilization, which is not possible for the cases mentioned below.

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  • Issues with the sperm binding to the egg and penetrating it
  • Anti-sperm antibodies. These are protective or immune proteins that attach to sperm and destroy it.
  • Previous failure in fertilization with conventional fertilization methods or IVF culture despite repeated attempts.
  • When the sperm is frozen for collection before cancer treatment, their quality and number might be limited.
  • Cases in which sperm is absent because of blockage. The retrieval of sperm is then done either from the testis by a process known as TESA (testicular sperm aspiration) or from the epididymis by MESA (microsurgical epididymal sperm aspiration) procedure.

ICSI is very effective and recommended for the above-mentioned cases. ICSI is not an effective method for treating female factor infertility which includes infertility that results from poor quality of eggs.

ICSI procedure - steps involved

Micromanipulation is the name of the technology used for ICSI procedure. An inverted microscope is used in the technique, for enabling embryologists to choose and pick up individual sperms in a special ICSI needle. There are 5 basic steps which are followed by the specialist. Those include -

  • Holding the mature egg with a specialized pipette.
  • Single sperm is immobilized and picked up by a very sharp, hollow and delicate needle.
  • The needle is then advanced into the cytoplasm of the egg into the shell of the egg very carefully.

Must Read: Intracytoplasmic Sperm Injection (ICSI)

  • The need is removed carefully after injecting the sperm into the cytoplasm.
  • After a day of injection, the eggs are inspected for fertilization after 19 hours of fertilization.

The fertilized embryo is grown for a maximum of 5 to 6 days. One or two transferred into the uterus of the female for implantation to take place.

ICSI is very useful for male factor infertility patients and previous IVF failure patients. The success rate is very good with ICSI up to 80%.