Intracytoplasmic sperm injection (ICSI) can be seen as an extent of your IVF procedure or even performed as an independent treatment procedure. It is a procedure in which an embryologist inserts a single sperm into the cytoplasm (centre) of each egg. After the embryologist inseminates the egg with the sperm, he then leaves the petri dish for a few days. he observes the eggs over this duration to check if the fertilized egg would be suitable to transfer into the womb or not.
The ICSI treatment procedure helps women and men deal with infertility issues. It helps men to improve their sperm count and deal with ejaculation issues. For women, improves the quality of their eggs and boosts their fertility.
For women, the doctor first needs a detailed account of the woman’s fertility cycle. For a normal ovarian cycle, the egg matures on 14th day of cycle in a normal 28 days cycle. Before doing ICSI (Intracytoplasmic sperm injection) procedure, the doctors would advice the women to certain prescription drugs, injections and other treatments to check if the procedure is compatible with their bodies. Ensure that you ask your doctor all the questions that you might have about the procedure and be aware of the risks involved before you decide.
Here is a detailed description of the ICSI procedure step by step to give you a better idea of what exactly happens-
First and foremost, the ovary of the woman has to be inspected and prepared for the ICSI process. The menstruation cycle is regulated for 2-3 weeks to check when are your most fertile days. It also checks when the womb is thick or thin to get the eggs attached to the endometrium layer. Women are also exposed to certain fertility drugs and have to regulate their health care regime for ovarian stimulation. You might even be recommended nasal medications and sniffing products and injections as well.
The injections are administered by the doctor via ampoules and vials, where the water is mixed with the medication before being injected in the body. Talk to the doctor about the procedure and how it would affect your body. The ovary simulation process takes roughly 10-12 days to completely prepare the womb. Ensure that you get scans and blood tests at regular intervals to keep a track of your progress.
Doctors are constantly checking if the endometrium layer is thick enough or the follicles contain any eggs or not. It would be best if you get your injections on the same day. Some of the common side effects of these simulation injections include abdominal bloating, nausea, diarrhoea, weight gain, fatigue, and even cramps. Contact your doctor if you feel any of these effects.
Egg collection is the next step in the ICSI treatment process. Once the ovary is simulated and deemed ready by the doctor, the patient will be wheeled into the operation theatre. In the theatre, the patient would be injected with anesthesia and given painkillers to help them cope with the procedure.
When the doctors have checked and confirmed the maturity of the follicles, they will size the ovaries on scan and use a trigger injection (Gonasi, Ovitrelle or Suprecur ). These dosages are generally supervised and given in roughly 35 to 36 hours before your programmed egg collection procedure. It is important that the injection is given at the right time, i.e. about a day before for scheduled appointments. Doctors prefer to administer the injection in the evening, as the patient gets better time and rest at night for better effectiveness. You are not allowed to eat or drink anything during the night after the injection has been given.
The next morning, the patient is sent in for egg collection where the doctor takes some eggs from the ovaries. You may be advised to avoid intercourse 3-5 days before fertilization. This ensures that there is a better chance for the sperm to fix on the womb. Egg retrieval and collection takes roughly 20-30 minutes. The male partner is then asked to supply his sperm sample which is checked and if approved, injected into the egg. You can even opt for pre-frozen sperms for the procedure as there is not much of a difference.
Let us now explain the process in detail- each egg sac (follicle) in the ovary is first identified and then pierced under the supervision of an ultrasound scanner. The ICSI Treatment Procedure is completed via a fine needle, the ruptured follicle is then injected with fluid before it is drawn out and collected in a warm and sterile dish. This sample is then observed under the microscope to check if it is ready or not.
After the eggs are collected, you can be ready for a medical procedure called progesterone support in which the Cyclogest suppositories and/or Lubion injection is given once or twice a day. Progesterone is a hormone that boosts the womb and develops the endometrium lining to fertilize the embryos. The process is continued and every time you have to take a pregnancy test to check if there is any positive result. Doctors might also include oestrogen tablets, blood thinning injections (Clexane) and steroids to advance the chances of pregnancy.
Now, the doctors and specialists have to carry on with the ICSI steps in the lab. IVF treatment uses roughly 100,000 good quality sperm and adds them to the eggs artificially. The entire process takes place in a petri dish and placed in an incubator to keep the eggs warm and comfy.
In ICSI, there is a slight difference, as doctors perform this process using a single egg and sperm. Lab officials are also very strict at regulating the eggs, witnessing the different stages of the progress to check if things are going as per plans and there aren’t any errors. The next morning, the eggs are examined under the microscope and the fertilization is completed.
The last and final step of the ICSI Treatment Steps that you can check if the embryo is ready to be transferred to the womb. The embryos can be moved within 3-5 days, in some cases, you might also have to wait for 6 days.
Embryos on the 5th day are called blastocyst, as they have developed into a stage that can be attached to the uterus. Also if the eggs have reached this stage, then your chances of pregnancy are significantly higher.
The embryo when it becomes a substantial cluster of 6 to 8 cells, is transferred under the supervision of an expert, You can even request for your partner to be present in the hospital when the embryo transfer is taking place.
To explain the process in detail- a speculum is inserted in the vaginal passage to get a clear view of the cervix. This allows the doctor to locate the exact position where the embryo has to be transferred. The embryos are then slowly drawn into the cervix via a fine catheter tube. The entire process taken but 10 minutes but requires extreme caution and precision.
ICSI step by step treatment is a quick but meticulous process that requires supervision and expertise. Ensure that you get it done at a reputed and credible hospital or medical clinic.
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