Intra Cytoplasmic Sperm Injection (ICSI) is an assisted reproductive technique where in a single sperm is injected into the cytoplasm of the oocyte (egg) with the help of special micromanipulators. This technique was initially used only for severe male factor infertility but is now being used to increase the chances of fertilization in other patients undergoing IVF cycles too. Which patients should get IVF/ICSI done? Patients with
With ICSI, the sperm do not have to travel to the egg or penetrate the outer layers of the egg. Therefore it can help men whose sperm are too few, or cannot move properly, or where the sperm can get to the egg, but are unable to fertilize it for some reason. In conventional IVF, the eggs collected from the womens body were put in a petri dish with the partners sperm and the sperms themselves had to enter the egg and fertilize it. This led to a higher chance of fertilisation failure both in men with poor quality sperms and in slightly older women with harder egg shells. This drawback is overcome with the ICSI technique as here, using a very powerful microscope and very fine needle (micromanipulator), a sperm is injected into each egg thus facilitating fertilisation. How is sperm retrieved for use in IVF/ICSI? Needle aspiration or microsurgical sperm retrieval are good alternatives when a competent microsurgical vasectomy reversal has failed, or when the man is opposed to surgery. Needle aspiration allows physicians to easily and quickly obtain adequate numbers of sperm for the ICSI procedure. A tiny needle is used to extract sperm directly from the testis. Needle aspiration is a simple procedure performed under sedation with minimal discomfort; however there is potential pain and swelling afterwards. The sperm obtained from testis is only appropriate for ICSI procedures when testicular sperm is not able to penetrate an egg by itself. How is IVF/ICSI done? What is the success rate for ICSI? The success rate of ICSI is increasing as more and more clinics become experienced in this technique. The overall average success rate for women under 35 years is around 40 to 45%. What are the advantages of ICSI? ICSI opens doors to parenthood that were previously closed for couples with a male factor problem. It gives men with absent, few or immotile sperms the chance to have their own biological child, which might not have been possible without this technique. Sperms can also be retrieved from the testes of men who have in the past undergone a vasectomy that now cannot be reversed. Are there any disadvantages of ICSI? Nature follows the principle 'Survival of the fittest'. During normal conception, only the hardiest sperm manage to travel great distances and break through the membrane of an egg to fertilize it. Weaker sperm never make it. Because ICSI bypasses this process of natural selection, critics worry about higher rates of miscarriage, and long-term health & developmental problems for children conceived using whatever sperm are available. Research so far has been reassuring about most potential risks. No impact has been seen on the cognitive and motor skills of children conceived using IVF/ICSI. Letters to Dr. Richa Katiyar regarding ICSI Dear Dr.Richa, Please let me know the success rate for ICSI treatment? Could you please mail the clinic address, i am living in Noida, so if at all you do consultation in any of the hospitals in Noida also, then please let me know. Regards, Amna Dear Amna, Success depends on many parameters like your age, your AMH report, AFC, condition of the uterus, semen parameters etc. I will do your USG when you come to visit me and go through all your previous reports and will then be able to give you the success chances in your case. Unfortunately I do not visit any Hospitals in Noida. My Clinics address is: Dr. Richa Katiyar Sector D, Pocket 2, House No. 2482, Vasant Kunj, New Delhi. Regards, Dr. Richa I am Adil from Dacca. Age 35+ and my wife age 33+. We have no baby after long time. we are trying in bangladesh in different doctors but we can't success. We want to go to your hospital recently. Can we any benefit from you. My sperms morphology is not good. Thanks. Hello Mr. Adil, Even with average morphology, we can get good results in ICSI technique as the sperms are selected individually under high magnification. Dr. Richa |