Intracytoplasmic Sperm Injection (ICSI) is a fertility treatment used with IVF. Unlike conventional IVF, where sperm and egg meet naturally, this procedure involves injecting a single sperm directly into an egg. This is especially beneficial for couples facing male infertility, previous IVF failures, or unexplained infertility.
Who needs ICSI?
ICSI is recommended for:
- Severe male infertility.
- Unsuccessful fertilization in past IVF cycles.
- If you require genetic testing before embryo transfer.
- Sperm retrieval through surgical methods.
Step 1: Ovarian stimulation
To increase the likelihood of fertilization, the ovaries are stimulated to create numerous eggs as the first step in the ICSI process. Gonadotropins and other fertility drugs are provided to promote the growth of several follicles. To guarantee a safe and efficient response, follicle growth and hormone levels are tracked during this phase by routine ultrasounds and blood tests. To complete egg maturation in preparation for retrieval, an initial injection of human chorionic gonadotropin (hCG) or a comparable hormone is given once the follicles are at their ideal size.
Step 2: Egg retrieval
About 34–36 hours after the trigger injection, the mature eggs are collected through a minor surgical procedure known as transvaginal ultrasound-guided egg retrieval. This is performed under mild sedation or anesthesia to ensure comfort. A thin needle is carefully inserted into each follicle to aspirate the eggs, which are then transferred to a specialized lab for assessment. The procedure is quick, usually taking 15–20 minutes, with minimal recovery time. Some patients may experience mild cramping or bloating afterward.
Step 3: Sperm collection and selection
On the same day as egg retrieval, a sperm sample is collected from the male partner through natural ejaculation or, in some cases, surgical sperm retrieval techniques like TESE (testicular sperm extraction) or PESA (percutaneous epididymal sperm aspiration) for men with low sperm count or blockages. In the lab, embryologists use techniques to select the most viable sperm for fertilization.
Step 4: Microinjection Process
ICSI differs from conventional IVF by directly injecting a single, carefully chosen sperm into each mature egg. This is done using a micromanipulator under a high-powered microscope. This method skips barriers that may prevent fertilization, making it particularly effective for couples dealing with severe male infertility factors, such as low sperm count, poor motility, or abnormal sperm morphology.. The injected eggs are then placed in an incubator for observation.
Step 5: Embryo culture and monitoring
Following fertilization, the embryos are cultured in a controlled environment for 3–5 days. During this period, embryologists monitor their development, assessing factors such as cell division and morphology to determine embryo quality. In some cases, preimplantation genetic testing (PGT) is conducted to screen for genetic abnormalities, which can help improve the chances of a successful pregnancy and reduce the risk of inherited disorders.
Step 6: Embryo transfer
Once the embryos reach the optimal stage of development, the best-quality embryo is selected for transfer into the uterus. Using a thin, flexible catheter, the embryo is gently placed into the uterine lining under ultrasound guidance. This procedure is painless and requires no anesthesia. Any remaining [quality] embryos can be cryopreserved for future use, offering additional chances for pregnancy in subsequent cycles without the need for ovarian stimulation and retrieval
Step 7: Pregnancy test
About two weeks after embryo transfer, a blood test measures levels of hCG to determine whether implantation was successful.
Benefits of ICSI
- Higher fertilization rates: increases chances of successful conception.
- Effective for severe male infertility: overcomes sperm-related challenges.
- Compatible with genetic screening: reduces risks of inherited disorders.
- Useful for previous IVF failures: helps couples with past unsuccessful attempts
Mumbai has some of the most advanced fertility centers, offering new technology and highly experienced specialists. For couples seeking the best ICSI treatment in Mumbai, top clinics provide care with a patient-centric approach, making it a trusted destination for fertility solutions.
References:
- https://thaisuperiorart.com/news-and-articles/4509/
- https://my.clevelandclinic.org/health/treatments/22463-intracytoplasmic-sperm-injection
- https://www.novaivffertility.com/fertility-help/when-is-icsi-recommended
