Infertility is one of the major issues that prevent the dream of parenthood from being fulfilled. However, with the advancements of modern medicine, there are many ways to counter this problem. Among many methods of going past the issue of infertility, one of the best options you have is Intracytoplasmic Sperm Injection or ICSI for short. The issue here is that not many people know what this treatment is or how it works. If you are someone who has heard of this treatment and is curious about the ICSI procedures step by step, then you have come to the right place.
In this blog, we provide you with a brief overview of the ICSI procedure step by step, along with various additional information such as the duration of ICSI treatment, some of its risks, and when it is recommended. So, keeping this in mind, let’s get started!
Before we go into details regarding the ICSI, let’s first talk about when this treatment is recommended. ICSI is an infertility treatment method that is commonly recommended when natural fertilization is difficult or unlikely, primarily due to male infertility factors. Some of the most common scenarios when ICSI may be recommended include:
After discussing the phase when ICSI is recommended, let’s also discuss another one of the most asked questions regarding ICSI- its duration. The question in target is “How long does ICSI take?” well the specifics depend on the procedure used. However, we can provide you with an estimated duration when a general procedure is taken into consideration. The estimated duration of the ICSI process in consideration of the general procedure includes:
When we combine all of these time durations, we get a rough estimation of roughly 5 to 7 weeks from the start of the consultations to the pregnancy test.
When we provided you with the time estimation prior to this, we provided you with a general list of steps involved in the ICSI. Now, let's go into details regarding the provided steps.
As the first step of the ICSI process, in this step, you take a consultation with a fertility specialist. During this phase, both you and your partners take medical evaluations, which include blood tests, ultrasound scans, and semen analysis to check the reproductive health of both you and your partner. The doctor then reviews your medical history and confirms whether ICSI is the best option for you or not. If the treatment is approved, you then receive a personalized treatment plan, which also includes hormonal medications, lifestyle recommendations, and a treatment schedule. The initial phase lasts for 1 to 2 weeks, which allows for pre-treatment assessment and preparations.
The second stage of the Intracytoplasmic Sperm Injection (ICSI) is the ovarian stimulation phase. In this phase, the female partner receives hormonal injections which are designed to stimulate the ovaries to produce multiple mature eggs. The medication given during this process is typically gonadotropins, which aid in the development of multiple follicles. During this phase, you need to go through regular monitoring through blood tests and ultrasound scans. These tests are done to track the follicular growth and hormone levels. Once the follicles reach the desired size, the experts then do a trigger injection to induce the final maturation of the eggs, preparing them for retrieval. As mentioned prior, this strep lasts for around 10 to 14 days.
The third step of the ICSi process occurs roughly 34 to 36 hours after the trigger shot. In this phase, the eggs are retrieved using a minimally invasive procedure. This process is also known as transvaginal ultrasound-guided aspiration, and it is performed under mild sedation or anesthesia. The anesthesia is given to ensure comfort and a painless procedure. Once you are sedated or under anesthesia, a small needle is inserted into the ovaries through the vaginal wall to connect the mature eggs. At the same time, the male partner provides the fresh sperm samples on the same day. On the flip side, do note that you can also use previous frozen sperms during this process. If the previously frozen sample is used, then it needs to be processed and thawed before usage,
This is the step where the magic takes place and is the key step of the ICSI. As its name states, in this process, the ICSI fertilization takes place, or in other words, in this place, the sperm is taken from either the male or from the frozen sperm sample before it is directly injected into the mature egg using a fine microneedle. This precise technique is highly helpful for bypassing any barriers that might prevent natural fertilization, making ICSI one of the highly effective treatments for couples with male fertility issues. The injected eggs are then kept in a controlled incubator to allow for fertilization. Over the proceeding 16 to 18 hours, the experts examine the eggs under the microscope to confirm whether the eggs are successfully fertilized or not while ensuring that they develop into viable embryos.
If and when the experts have confirmed that the fertilization is completed, these embryos are then cultured in a specialized incubator under ideal conditions for around three to five days. During this period, the embryologist closely monitors the growth of the embryos. For this, the experts use advanced techniques such as time-lapse imaging. Regardless of the tools and techniques used, by the end of this phase, the best-quality embryo is selected for transfer. If there is more than one healthy embryo, you can freeze and store them for future use.
Following the process of embryo culture and monitoring, the next process step is the process of embryo transfer. In this step, the embryo that has reached a specific stage is carefully transferred into the uterus through a simple and painless procedure through the use of a thin catheter. This step is performed on the third or fifth day after fertilization, depending on the specifics of the embryo, and in this process, the doctor uses ultrasound guidance to ensure precise placement of the embryo in the uterine cavity. While embryo placement can get a bit uncomfortable, you do not need any form of anesthesia. Furthermore, the entire process only takes around a few minutes, and once the process is complete, you may need to rest for some time and follow post-transfer care instructions to maximize implantation chances.
Also known as the 2WW period, the seventh stage is all about waiting for the perfect time to conduct the pregnancy test. Now, you do have to note that although this period is known as the two-week wait period, the duration is not exactly two weeks but rather somewhere between 10 and 14 days. During these days, you, as the female, continue to take hormonal medications, which include the likes of progesterone for supporting implantation and for early pregnancy. Needless to say, this period is a highly important stage of pregnancy, but at the same time, this period can also be an emotionally challenging phase. This is because during this phase, the outcome of the treatment remains uncertain, and for someone who is waiting for the results, it can be emotionally stressful. However, just because it is an emotionally stressful period, it does not mean that you can indulge in your comfort foods and activities. The experts recommend that you need to maintain a healthy lifestyle while avoiding stress and refraining from taking any form of early pregnancy tests, as these tests can provide you with misleading results.
Know more about: Signs of Failed IVF in the Two-Week Wait (2WW)
This is the final step of the ICSI process. In this process, you take a blood test (beta-hCG test) to determine if the implantation was successful or not. If the test is positive, then the experts conduct some more ultrasound tests to monitor the baby's progress. If the test is negative, then the experts discuss the possible causes and then plan the next steps, which also include the option of using frozen embryos for the next transfer or using other forms of Assisted Reproductive Technology (ART) for better chances. Regardless of the outcome, the process of ICSI ends with this step alongside some form of counselling, guidance, and emotional support to support your next decisions.
Now when discussing ICSI, knowing the steps is good and all. However, along with the steps and procedures, you should also be aware that just like any medical process, ICSI also has its own share of risks as well. The question is, what are the risks of ICSI? Well, some of the most significant risks of ICSI are:
Now, do note that while these risks are undoubtedly present, the chances of these risks are rather low and the only common, if we can call it that, a form of risk is ICSI failure. Regardless, we hope you found this helpful.
Want a Successful ICSI Treatment?
Then read this: Does ICSI Increase Your IVF Success Rate? Expert Insights
Before we conclude, let's talk a bit about where you can get the best ICSI treatment in Nepal. Well among many IVF centers in Nepal, one of the best places to get ICSI treatment in Nepal is Hardik IVF and Fertility Center, the best ivf center in Nepal. But why is Hardik IVF one of the best in Nepal? Some of the most significant reasons for this include the following:
Infertility is one of the hardest hurdles one can face in their dream of parenthood. However, this hurdle is not impassable as there are many ways you can fulfill this dream even if you face this issue. One such issue is ICSI, which is a procedure where one sperm is selected and directly injected into the egg later. Now, of course, what we have mentioned above is merely the basic concept of the process. However, we have provided you with a complete ICSI procedure step by step in this blog.
We hope this was enlightening for you. To know more about ICSI and other related subjects on the treatment of infertility, read some of our other blogs. And for the best ICSI treatment in Nepal, get in touch with Hardik IVF and Fertility Center. Thank you for reading till the end.
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ICSI has a high success rate, with fertilization occurring in about 70%–85% of injected eggs. However, the overall pregnancy success depends on factors like egg quality, sperm health, and the woman’s age. The majority of couples conceive in the first cycle, although some will need multiple attempts.
To have the best possible chance of ICSI success, follow a healthy lifestyle with proper nutrition, exercise, and stress alleviation. Take medications as directed, avoid smoking and alcohol, and take prenatal supplements like folic acid. Your physician may also prescribe some hormonal pills to prepare your body for treatment.
Embryologists select the most motile and healthy sperm on the basis of shape and health through sophisticated microscopic techniques. The healthiest sperm are separated based on specific procedures like the swim-up test or density gradient centrifugation. One healthy sperm is injected directly into the egg to be fertilized.
ICSI can be done even with extremely low sperm count since only one good sperm is needed per egg. Unlike conventional IVF, where sperm must naturally penetrate the egg, ICSI bypasses this requirement. Even men with severe male infertility, including azoospermia (no sperm in the ejaculate), may be candidates if sperm can be retrieved surgically.
There is no absolute minimum, but doctors will often aim to retrieve a minimum of 8–15 mature eggs to increase the chances of success. Since not all eggs will fertilize or develop into a healthy embryo, the more eggs, the greater the chances of a successful pregnancy. Quality over quantity is more significant, however, and even fewer eggs can be effective in some cases.
Proper nutrition, lifestyle, and avoidance of toxins like alcohol and smoking can enhance egg and sperm quality. Following the doctor's prescriptions for hormonal medicines and supplements is very important. Also, newer lab techniques like embryo freezing and genetic screening also enhance the results.
ICSI is a form of IVF that consists of the injection of a single sperm straight into the egg to bypass natural fertility obstacles. Natural insemination of the egg by sperm within a culture dish is routine IVF and needs more sperm. ICSI is only reserved for extreme male infertility, while IVF addresses more varied causes of infertility.