ICSI is one of the newly developed successful techniques to treat male infertility. ICSI or Intra-Cytoplasmic Sperm Injection is an artificial fertilisation procedure used during In-Vitro Fertilization (IVF) treatment to help a woman conceive.
In ICSI, one, healthy sperm is selected and is directly injected into a healthy, female egg. The embryo (fertilised egg) is then implanted into the mother’s womb.
- The collection of the female egg: Similar to the IVF protocol, fertility-inducing drugs are prescribed on a monthly basis to stimulate the ovaries to generate several mature eggs. Ovulation i.e. release of these eggs by ovaries is monitored by the doctor by means of examination and blood tests. On the day of ovulation, the doctor collects the eggs using a fine, hollow needle under ultrasound guidance. The procedure is performed under local anaesthesia. These eggs are frozen and stored till they are used for creating the embryo.
- The collection of the sperm: The sperms are collected from the male on the same day by self-ejaculation in a cup. If the semen contains an inadequate quantity of healthy sperms, sperms are collected using an aspiration technique. In this procedure, sperms are directly collected from the testis or epididymis using a fine needle under local anaesthesia. Occasionally, a testicular biopsy may be done to obtain the sperm.
In a specialised lab, an expert embryologist isolates individual sperms from the sample. These are then injected into individual eggs to fertilise them. A fertilised egg develops into a small ball like structure called the embryo within 2 days. The embryo is then implanted into the mother’s womb by use of a thin catheter passed inside through the cervix. Occasionally, a five-day-old embryo is implanted, to ensure survival. The embryo then attaches itself in the womb and the pregnancy continues.
For women under 40 years of age, 1-2 embryos are implanted and for above forty years, a maximum of three embryos are implanted.
One cycle of ICSI lasts about 4-6 weeks. The male and female partners are expected to be at the clinic for 1 full day for retrieval of sperm and egg. After embryo transplant, the mother is discharged between 2nd to the 6th day.
Who can opt for ICSI?
- Infertility caused due to inability of the sperm to penetrate the egg can be overcome
- Infertility due to low sperm count.
- Infertility due to abnormal sperm shape.
- Infertility due to the poor motility of sperms.
- Problems of erection and ejaculation, where the production of sperm is still intact, and they can be collected from the tests directly.
Pros and cons
- A superior finely-tuned technique to treat infertility.
- Very High chances of pregnancy and childbirth
- Near-zero risk to health of female/male partners
- It is slightly expensive
- Being an artificial procedure, there is a chance of a weaker sperm being selected for conception. This may increase the risk of genetic problems in the child which may go undetected during pregnancy.
- The artificial technique increases the risk of congenital anomalies in the baby by 6 percent.
The procedure is undertaken under thorough supervision by expert and experienced doctors.