Intra-Cytoplasmic Sperm Injection (ICSI)

Intracytoplasmic sperm injection, or ICSI, involves injecting a single live sperm directly into the center of a human egg. The method was created to assist couples who have failed to conceive after an unsuccessful effort at in vitro fertilization (IVF) or who have severe male factor infertility. Many of the obstacles for fertilization are removed by the technique, which enables couples who have little chance of becoming pregnant to acquire fertilized embryos.

For multiple mature eggs to develop, the female partner must undergo ovarian stimulation with fertility medicines as part of the treatment. Following their aspiration through the vagina using vaginal ultrasonography, the eggs are carefully cultured in the embryology lab under carefully controlled conditions. Centrifuging, or spinning, the sperm cells through a certain media, yields a sample of sperms. This separates most of the dead sperm and detritus from the living sperm. Next, using a glass needle, the embryologist inserts the lone viable sperm into the egg.

The procedure itself was first performed in 1987, though it only went to the pronuclear stage. The first activated embryo by ICSI was produced in 1990, but the first successful birth by ICSI took place on January 14, 1992, after an April 1991 conception.

ICSI is recommended in the following cases:

• Men who have issues with sperm motility, sperm count, or sperm morphology
• Men who have undergone vasectomy;
• Testicular biopsy sperm;
• Samples of cryopreserved semen

-Low egg number

-Poor oocyte quality with thick wall

-Failed fertilization during conventional IVF in previous cycle

-Microinjection of vitrified oocytes

-Genetic or chromosomal analysis of embryo

  A tiny percentage of eggs— less than 5 percent—may be harmed by the needle insertion during the ICSI process. This can be reduced to zero with experienced Embryologist. The age of the mother increases the chance of having a chromosomal defect such as Down syndrome, but not with ICSI. 

Ovarian Stimulation: In a natural menstrual cycle, the ovaries typically produce one egg. During an IVF cycle, medication is administered via injections to stimulate follicle growth, aiming to produce multiple eggs. Regular ultrasound scans at the clinic monitors follicular development. Once follicles reach optimal size, the stimulation phase concludes.
Follicular Puncture (Egg Retrieval): After administering a trigger shot (to induce egg maturation), egg retrieval is scheduled 34-36 hours later. This is a day care procedure where eggs are collected from the ovaries transvaginal under local or general anesthesia using ultrasound guidance.
Oocyte Fertilization and Embryo Culture: On the day of egg retrieval, a semen sample is collected and prepared. An embryologist performs intracytoplasmic sperm injection (ICSI), injecting a single sperm directly into each egg. The method of fertilization is determined by the doctor and embryologist based on individual circumstances to optimize success. Fertilization is assessed approximately 17 hours post-injection using specialized incubators equipped with monitoring systems for safety and accuracy.
Embryo Transfer: Embryo development is monitored daily, and the doctor and embryologist determine the optimal time for embryo transfer to maximize pregnancy chances. Using ultrasound guidance, embryos are transferred into the uterus via a soft catheter in a simple, painless procedure that does not require sedation or anesthesia. Bed rest after embryo transfer is typically not necessary.

By facilitating the fertilization of the sperm and egg, intracytoplasmic sperm injections, or ICSIs, can aid men experiencing severe infertility. When a male component or a history of unsuccessful IVF fertilizations is the root cause of infertility, ICSI increases the likelihood of a successful pregnancy for those couples. One of the most effective developments in assisted reproduction technology is in vitro fertilization (ICSI), which enables men with severe male factor infertility to become parents to their own biological children.