IVF ICSI



 

The meaning of IVF is in –vitro-fertilization .
ICSI stands for intra cytoplasmic sperm injection.
During regular IVF, many sperm are placed together with an egg, in hopes that one of the sperm will enter and fertilize the egg on its own.
With ICSI, the embryologist takes a single sperm and injects it directly into an egg.
Some fertility clinics recommend ICSI for every IVF cycle. Others reserve the treatment for those with severe male infertility or another medically indicated reason.
IVF, ICSI has enabled many infertile couples to get pregnant when, without it, they would not have been able to conceive using their own eggs and sperm.

IVF ICSI Indications:

IVF -ICSI is typically used in cases of severe male infertility, including:

  • Very low sperm count (also known as oligospermia)
  • Abnormally shaped sperm (also known as teratozoospermia)
  • Poor sperm movement (also known as asthenozoospermia)

If a man does not have any sperm in his ejaculate, but he is producing sperm, they may be retrieved through testicular sperm extraction, or TESE.
Sperm retrieved through TESE require the use of ICSI.
ICSI is also used in cases of retrograde ejaculation if the sperm are retrieved from the man's urine.

Severe male infertility isn’t the only reason IVF/ ICSI is used. Other reasons include:

  • Very few eggs were retrieved: in this case, ICSI may be used to improve the odds of having a healthy embryo to transfer.
  • Previous IVF cycle had few or no fertilized eggs: Sometimes, a good number of eggs are retrieved, and sperm counts look healthy, but no eggs get fertilized. In this case, during the next IVF cycle, ICSI may be tried.
  • Frozen sperm are being used: if the thawed sperm don’t appear especially active, ICSI-IVF may be recommended.

What Is the Procedure for IVF/ ICSI?

As with regular IVF, lady will take ovarian stimulating drugs, and we will monitor her progress with serial ultrasounds and occasional blood tests. Once enough good-sized follicles are formed, the egg retrieval is done, where eggs are removed from ovaries with a specialized, ultrasound-guided needle. This retrieval of the eggs is done under short anaesthesia or sedation, so that the lady undergoing treatment won’t get any pain.

Husband provides his sperm sample that same day (unless a sperm donor or previously frozen sperm is used.)

In case of IVF the obtained eggs are kept in a petri-dish containing a special media and washed sperms are kept in same media.

Theses sperms will unite with the eggs on their own. Fertilization is then checked on next day. Fertilized embryos are then transferred in another media and allowed to grow for further three to five days. These embryos are monitored daily for the growth. On third or fifth day, one or two embryos are then transferred inside the uterus through a small delicate plastic catheter. The lady is given progesterone injections/ passaries and supportive medicines. Positive result is generally checked by doing lady’s blood test of beta hcg.

While in ICSI, once the eggs are retrieved, an embryologist places the eggs in a special culture, and using a microscope and tiny needle, a single sperm is injected into an egg. This is done for each egg retrieved.

If fertilization takes place, and the embryos are healthy, an embryo or two will be transferred in to the uterus, via a catheter placed through the cervix, two to five days after the retrieval.

What Are the Risks of IVF/ ICSI? Is It Safe for the Baby?

A normal pregnancy comes with a 1.5% to 3% risk of major birth defect. ICSI treatment carries a slightly increased risk of birth defects, but it's still rare.

Some birth defects are more likely to occur with IVF/ ICSI, specifically Beckwith-Wiedemann syndrome, Angelman syndrome, hypospadias, and sex chromosome abnormalities.

They occur in less than 1% of babies conceived using ICSI with IVF.

There is also a slightly increased risk of a male baby having fertility problems in the future. This is because male infertility may be passed on genetically.

Procedure for IVF/ ICSI:

As with regular IVF, lady will take ovarian stimulating drugs, and we will monitor her progress with serial ultrasounds and occasional blood tests. Once enough good-sized follicles are formed, the egg retrieval is done, where eggs are removed from ovaries with a specialized, ultrasound-guided needle. This retrieval of the eggs is done under short anaesthesia or sedation, so that the lady undergoing treatment won’t get any pain.
Husband provides his sperm sample that same day (unless a sperm donor or previously frozen sperm is used.)
In case of IVF the obtained eggs are kept in a petri-dish containing a special media and washed sperms are kept in same media. Theses sperms will unite with the eggs on their own. Fertilization is then checked on next day. Fertilized embryos are then transferred in another media and allowed to grow for further three to five days. These embryos are monitored daily for the growth. On third or fifth day, one or two embryos are then transferred inside the uterus through a small delicate plastic catheter. The lady is given progesterone injections/ passaries and supportive medicines. Positive result is generally checked by doing lady’s blood test of beta hcg.
While in ICSI, once the eggs are retrieved, an embryologist places the eggs in a special culture, and using a microscope and tiny needle, a single sperm is injected into an egg. This is done for each egg retrieved.
If fertilization takes place, and the embryos are healthy, an embryo or two will be transferred in to the uterus, via a catheter placed through the cervix, two to five days after the retrieval.

Risks of IVF/ ICSI? Is It Safe for the Baby:

A normal pregnancy comes with a 1.5% to 3% risk of major birth defect. ICSI treatment carries a slightly increased risk of birth defects, but it's still rare.
Some birth defects are more likely to occur with IVF/ ICSI, specifically Beckwith-Wiedemann syndrome, Angelman syndrome, hypospadias, and sex chromosome abnormalities.
They occur in less than 1% of babies conceived using ICSI with IVF.
There is also a slightly increased risk of a male baby having fertility problems in the future. This is because male infertility may be passed on genetically.

Success Rate for IVF/ ICSI:

The ICSI procedure fertilizes 50% to 80% of eggs.
You might assume all eggs get fertilized with IVF/ ICSI, but they don’t. Fertilization isn’t guaranteed even when a sperm is injected into the egg.
Also, even if fertilization takes place, the embryo may stop growing.
However, once fertilization happens, the success rate for a couple using ICSI with IVF is the same as a couple doing regular IVF treatment.