Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic Sperm Injection (ICSI) is a highly effective treatment for male infertility and is often used when conventional In Vitro Fertilization (IVF) fails. This method involves directly injecting a single sperm into an egg and is also utilized when sperm needs to be surgically extracted.

What is ICSI?

ICSI is a specialized form of IVF designed to assist couples facing male fertility issues. It involves the injection of a single sperm directly into an egg, which can be crucial when the sperm count is low or other traditional methods have not succeeded. Female partners undergo ovarian stimulation with fertility medications to prepare for this process.

Who Should Consider ICSI? ICSI is a common approach, with around 75% of IVF treatments now including this technique. It is recommended for cases involving:

• Low sperm count

• Previous IVF attempts with poor fertilization rates

• Abnormally shaped or non-motile sperm

• Low-quality frozen sperm

• Post-vasectomy or other blockages affecting sperm delivery

Why Choose ICSI Over Traditional IVF?

While IVF typically involves placing multiple sperm in an egg to increase the chances of fertilization, ICSI involves the direct injection of a single sperm into the egg. This approach is particularly beneficial when previous IVF attempts have failed or when sperm quality is compromised.

How Does ICSI Work?

ICSI is integrated into the IVF process, where a single sperm is injected into an egg using a fine needle. After injection, the egg is monitored for fertilization and embryo development. Successful embryos are then transferred to the uterine cavity.

Steps in the ICSI-IVF Process:

1. Ovarian Stimulation: Women receive injections to stimulate the ovaries, monitored by regular scans and blood tests over 10-12 days.

2. Egg Retrieval: Performed under sedation or anesthesia, eggs are collected from the ovaries using a needle guided by ultrasound.

3. Sperm Collection: A semen sample is provided by the male partner, which is prepared and examined for the ICSI procedure.

4. ICSI Procedure: A single sperm is injected into each egg, which is then incubated. The eggs are monitored for fertilization and embryo development.

5. Embryo Transfer: Fertilized embryos are transferred into the uterus on day 2 to day 5, with a preference for transferring embryos that have reached the blastocyst stage.

Cost of ICSI Treatment: ICSI treatment in India is more affordable compared to many other countries. The cost typically ranges from Rs. 2,40,000 to Rs. 2,50,000 per cycle, depending on the complexity of the case. Advanced treatments may cost up to Rs. 4,50,000.

Risks Associated with ICSI: While generally safe, ICSI can pose risks such as:

• Multiple pregnancies

• Hormonal abnormalities in offspring

• Premature birth

• Developmental delays

• Heart defects

• Hypospadias

Pros and Cons of ICSI:

Pros: ICSI offers a solution for male fertility issues and can enable couples to conceive using the male partner's sperm. It is also a viable option for those who have undergone vasectomy or are using donor sperm.

Cons: Potential risks include complications from the techniques used for sperm recovery and the possibility of multiple pregnancies. Additionally, the process may lead to a higher incidence of birth defects.

Success Rate of ICSI: ICSI has a success rate of 50% to 80% for egg fertilization and is the most commonly used method for severe male infertility. It significantly improves the chances of conception compared to traditional methods.