Intracytoplasmic Sperm Injection (ICSI) –
Intracytoplasmic sperm injection(ICSI) is an assisted reproductive technology(ART) used to treat sperm related infertility problems. ICSI is used to enhance the fertilization phase of in vitrofertilization(IVF) by injecting a single sperm into a mature egg. The fertilized egg is then placed in a womans uterus.
Indications for performing ICS
1. Males with very low sperm count (less than 5 million), poor motility or higher percentage of abnormal sperms.
2. Males with azoospermia (when no sperms are present in semen). In case of obstructive or non obstructive types, sperms can be retrieved directly from testis using PESA/TESA/TESE.
3. Males with antisperm antibodies.
4. Males with ejaculatory dysfunction or retrograde ejaculation.
5. Patients with repeatedly failed cycles of IVF.
At Dr. Rama Sofat Hospital and Dr. Ruchika Test tube baby centre, we provide affordable ICSI treatment which consists of:-
1.Ovarian Stimulation with injections to produce multiple eggs which are monitored using transvaginal ultrasound and hormone (Estradiol) levels.
2. Administering injection HCG when at least two leading follicles reach a diameter of 18 mm.
3. Ovum pick up under short general anaesthesia usually 34-36 hours after HCG injection.
4. Isolation of eggs in the laboratory from the fluid.
5. Sperm collection and processing.
In case of azoospermia (no sperms present in the semen), the sperms are collected directly from the testis using PESA/MESA/TESE/TESA or FTNB.
6. Dissecting the eggs by using an enzyme (Hyaloronetis) which are then placed into small droplets of culture media under oil.
7. Placing sperm into small droplets of PVP under oil immobilizing the sperm with a microinjection needle and then aspirating immobile sperm into the needle (tail first).
8. Holding the egg with the holding pipette and injecting the immobilized sperm into the egg.
9. Placing these eggs into the incubator.
10. Embryo transfer on D3 or D5 of retrieval
The success rate of ICSI at our unit is about 30-40% which is comparable to those of best centres in the world.
Nowadays, some units are doing ICSI routinely for all patients including those who have normal sperm counts. But at Dr. Rama Sofat Hospital and Dr. Ruchika test tube baby centre, we advocate IVF for patients with normal sperms. For patients in the grey zone, we fertilize 50% of eggs using IVF and 50% of eggs using ICSI.