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Intracytoplasmic Sperm Injection (ICSI)

What is Intracytoplasmic Sperm Injection (ICSI)?

Intracytoplasmic Sperm Injection or ICSi is a form of Assisted Reproductive Technologies (ART) used alongside in vitro fertilization. This process involves electing the best sperm with the best mobility and injecting them directly into the fertile ovum with a microneedle. This embryo is then cultured inside a sterile laboratory until it reaches the fifth day of the embryo, also known as the blastocyst phase. Then, the doctors conduct the uterine transfer of the blastocyst to allow the continued development of the womb. It is regarded as a safe and highly effective medical technology for men with various forms of male infertility, such as unhealthy sperm and low sperm count. Furthermore, it is also helpful for those women with low egg counts, thick egg shells, or unhealthy uterus.

There are two ways to get the eggs fertilized using the ICSI method. They are ICSI IVF and ICSI IUI methods. They are as follows:

ICSI IVF treatment

This process involves the usage of fertility medicines to aid in the production of quality eggs and to stimulate the ovaries kept in the laboratory. The sperm and eggs are kept together after fertilization. The good quality sperms are then transplanted into the uterus for ICSI pregnancy at a later date.

ICSI IUI treatment

In this form of ICSI treatment, the sperm is inserted into the uterus during the time of ovulation to fertilize for pregnancy.

Who Uses Intracytoplasmic Sperm Injection?

There are various circumstances when a person requires an ICSI procedure. Some of the situations where this process is required are as follows:

  • If a male cannot ejaculate (known as anejaculation)
  • Blockage in the male reproductive system
  • Low sperm count
  • Poor sperm quality
  • If traditional IVF has not led to the creation of embryos
  • When the female participant is more than 35 years of age
  • If the couple is using frozen eggs or sperm to try and conceive.

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What Happens Before Intracytoplasmic Sperm Injection (ICSI)?

Before the process begins, the healthcare provider collects both eggs and sperm from the participants. For this to happen, the icsi procedure step by step are:

Ovulation Induction

In this step, the female participant takes medication injections for eight to fourteen days to stimulate the ovaries. This allows for the production of multiple eggs at once to mature.

Egg Retrieval

After the ovulation induction process, the doctor uses transvaginal ultrasound technology to guide the insertion of a thin needle through the vaginal walls into the ovaries. It is a mildly painful process, so mind anesthesia is used to assist in pain management.

Sperm Collection

The sperm is also collected from the male participant on the same day as the egg retrieval. If it is inconvenient for the male partner, the partner can come before for sperm collection. The sperm is frozen until the female partner is ready for egg retrieval.

  • Furthermore, the doctors also collect the sperm from the male participant as well. The male participant must follow the following rules before the ICSI treatment.
  • Abstain from sex and masturbation (and no ejaculation) for two to three days before the sperm collection.
  • Masturbation at home or in a private room at a fertility clinic to collect the ejaculation into the container provided by the lab. The sperm must be transferred into the laboratory within an hour from the ejaculation.

The analysis occurs immediately to check sperm volume, mobility, and quality. Furthermore, this process is also ideal for people who experience azoospermia, anejaculation, or retrograde ejaculation.

What is the Intracytoplasmic Sperm Injection Procedure?

After the reproductive experts from a trusted IVF and Fertility center clinic collect the sperm, the next phase of the process includes the following.

Intracytoplasmic Sperm Injection Fertilization

In this process, the embryologist selects the healthy mature eggs and places them on the lab dish. The egg is held firmly in a place with a pipette. Then, a single healthiest sperm is placed into the top of a thin glass needle before injecting it into the egg to achieve fertilization.

Embryo Culture

After the successful fertilization of the embryo, the embryologist cultures the embryo for three to five days. The experts monitor the embryo for the development of cell division until it reaches the blastocyst stage on the fifth day of fertilization.

The embryo is then cultured in a specialized nutrient solution in a controlled environment of the embryology laboratory, where a condition similar to the mother's womb is stimulated to support embryo growth. Then, the experts move to embryo grading and embryo transfer procedures.

The entire process can be summarized into the following points:

  • A small glass tube with a suction bulb to hold the mature egg in a lab dish
  • The expert picks one sperm using a thin needle
  • The sperm is injected into the egg to reach its cytoplasm
  • The needle is withdrawn from the egg.

What Happens After the ICSI Treatment?

After the intracytoplasmic sperm injection procedure, the healthcare experts follow two more steps before the completion of ICSI IVF. They are as follows:

Fresh Embryo Transfer

In this process, the experts place the embryo into the uterus during the induction-ovulation cycle. In this process, the doctors generally perform the embryo transfer within five to six days after the egg retrieval when the egg has reached the blastocyst stage.

Frozen Embryo Transfer (FET)

This form of embryo transfer happens in a succeeding embryo transfer to avoid the side effects of hyperstimulation syndrome, endometrial hyperplasia, or edema. The embryo is then frozen until necessary. When necessary, the embryo is thawed to proceed with the transferring procedure in the next nearest ovulation cycle.

Pregnancy Test

After the embryo is implanted into the uterus through ET or FET, the doctors schedule a pregnancy test. This is done around ten days after the embryo transfer procedure. Then, the obstetrician checks for pregnancy with a blood test to measure hormone levels and examine other conditions. Once the pregnancy is confirmed, the obstetrician proceeds with a follow-up appointment to check the mother's health. This includes tests through ultrasound scans to observe fetal development inside the womb periodically.

Vitrification

In this process, the good embryos are stored for later usage. These stored embryos are then used if the first cycle fails.

How Long Does Intracytoplasmic Sperm Injection Take?

The ICSI treatment takes around thirty minutes to an hour to complete and is completed five to six hours after the egg retrieval. This allows the eggs to mature.

However, before the ICSI, a sperm is prepared, which takes around two to three hours. Once the sperm is injected, the eggs are taken into an incubator, which takes around sixteen to twenty hours for successful fertilization. It takes around three to five days from egg retrieval to embryo transfer since the embryos need to reach the blastocyst state before the transfer.

All in all, the ICSI process in itself takes around an hour. However, if we include the time before and after the process, it takes around five to six days from egg retrieval to embryo transfer.

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What are the Benefits and Risks of ICSI Treatment?

In every medical procedure, there are some risks and benefits attached. Some of the key benefits and risks of ICSI treatment are as follows.

Advantages of ICSI Treatment

  • ICSI allows for fertilization even if the sperm count is low or there are motility issues.
  • It may improve the fertilization rate during cases of unexplained infertility when compared to IVF alone.
  • There is a low risk of failed fertilization as the sperm is directly injected into the egg.
  • It allows using frozen or donated sperm and eggs.

Risks of ICSI treatment

  • There is a 1% to 3% risk of damaging the egg.
  • There is a risk of the egg not being fertilized even after sperm injection.
  • The embryo may not develop in the lab or after embryo transfer
  • There is a risk of multiple pregnancy

How Much Does ICSI Treatment Cost in Nepal?

The specific intracytoplasmic sperm injection price depends on your circumstances. However, at Hardik IVF center, you can get intracytoplasmic sperm injection at the price range between Npr 3,50,000 to Npr 4,00,000.

Therefore, if you are looking for the best intracytoplasmic sperm injection treatment in Nepal, look no further than Hardik IVF and Fertility Center! Book your appointment and fulfill your dream of parenthood now!