WHAT IS ICSI?

Until the 90's, males with very low sperm count (less than 5 million per ml) or poor quality sperms had no hope of fathering children. However, Intracytoplasmic sperm injection, or ICSI, completely revolutionized the management of male factor infertility. With the advent of ICSI it now became possible to fertilize an egg as long as some sperm could be obtained (even if, in very low numbers). ICSI is now widely accepted and available in a large number of assisted conception units internationally.

Performed as part of In Vitro Fertilization (IVF) protocol, this fertility technique differs from traditional IVF in one unique way. Normally in IVF one egg is mixed with 100,000 sperms and one of the sperms fertilizes the egg on its own. Where as, in ICSI, the embryologist selects sperm from the sample and a single sperm is injected directly into each egg. This micro-fertilization is done with the help of a machine called the Micromanipulator.

INDICATIONS

ICSI is often recommended when:

• The male partner has a very low sperm count.
• The sperms are of a poor quality viz.; they have poor morphology (i.e. abnormal shape) and/or poor motility (i.e. the sperms do not move fast enough to reach the ovum to fertilize it naturally.)
• Problems in the male reproductive system prevent the sperms from being ejaculated and the sperms have to be collected from the testicles or epididymis (sperm reservoir). This procedure can also help those males to have children who have undergone irreversible vasectomy
• Failure of fertilization in a previous IVF cycle
• Recurrent failed IVF cycles
• Three or more miscarriages
• Also the procedure has been proven useful in cases, where the women fail to produce adequate number of eggs required for a normal IVF procedure.

STEPS IN ICSI

The procedure consists of the following steps:

• Controlled Ovarian stimulation with drugs (GnRH Analogues and Gonadotrophins) to produce many eggs
• Monitoring of follicles and egg development with the aid of vaginal sonography and serial Estradiol hormone estimation
• Administration of hCG injection, (Human Chorionic Gonadotrophins) when the two leading follicles are 18mm in diameter
• Oocyte or egg retrieval under short general anesthesia 35 to 37 hours after HCG injection
• Identification and isolation of eggs in the laboratory
• Sperm collection and processing in the lab. Incase of azoospermia (no sperms in the semen) the sperms are collected directly from the testis with the procedures of PESA/MESA/TESE or TESA
• Dissection of the eggs in the laboratory with the help of an enzyme called Hyloronetis. Placement of eggs into small droplets of culture media under oil
• Placement of sperms into small droplets of PVP under oil. Immobilization of the sperm with a micro-injection needle (Diameter of 7 microns) and aspiration of the immobile sperm into the needle (tail first)
• Holding the egg with a holding pipette and injection of the immobilized sperm into the held egg Placement of these eggs into the incubator for 2 to 5 days.
• Embryo formation 2 to 5 days after fertilization
• One to three of the best quality embryos are transferred to the womb. 2 days after egg removal (four cell embryo), 3 days after egg removal (six-eight cell embryo) or 5 days after egg removal (blastocyst transfer)

WHAT TO EXPECT AFTER TREATMENT

Overall, in vitro fertilization (IVF)-related injections, monitoring, and procedures are emotionally and physically demanding of the female partner. Superovulation with hormones requires regular blood tests, daily injections (some are quite painful), and frequent monitoring by your doctor. These procedures are done on an outpatient basis and require only a short recovery time. You may be advised to avoid strenuous activities for the remainder of the day.

#IVF, #IVF in India, #Fertility Treatment, #Fertility Treatment Abroad, #Infertility, #Infertility Treatment Abroad, #Surrogacy, #Surrogacy in India, #Savings, #Affordable Healthcare, #ICSI, #ICSI in India, #India, #Paradigm Healthcare, #Medical Travel, #Medical Tourism, #Treatment Abroad, #Treatment in India, #Surgery, #Low Cost Surgery, #Best IVF, #Best Surrogacy, #IVF Clinic in India, #Rotunda, #Kaberi Banerjee, #Rita Bakshi, #International Fertility Centre, #Indira Hinduja, #Gautam Allahbadia, #Dr.Malpani, #Shivani Sachdev, #Nova Fertility, #Shweta Mittal, #Anoop Gupta, #Dr.Pai, #Fertility Specialist, #Doctors, #Surgeons, #Gay Surrogacy, #Highest Success Rate in IVF, #Highest Success Rate in Surrogacy, #Low Cost Surrogacy, #Best Prices, #Best Quality, #Egg-Donor, #PGD, #Pre-implantation Genetic Diagnosis

      IVF | IVF in India | ICSI | IUI | Surrogacy | Surrogacy in India | Medical Travel | Medical Tourism