How ICSI can help in infertility?
October 7, 2019
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Techniques Used for ICSI

Techniques for ICSI

The recorded cases of infertility and the issues associated with it are higher than they have been ever before. The multi-faceted lifestyle of people is more hectic and stressful nowadays. As a result, procreation is usually not given much thought or even altogether avoided until pregnancy is actually desired. This is obviously not suited for the reproductive organs of both men and women. Thankfully, the advancements in medical science means there are effective ways to achieve pregnancy despite infertility.

Techniques Used for ICSI – When it comes to infertility treatment options, In Vitro Fertilization (IVF) is perhaps the most popular one today. It is a fertilization in which a sperm from a male donor is combined with an egg taken from the ovary of a female in an external controlled environment. The process is done by simulating the ovulatory movement of women. The mixing of the sperm and egg and fertilization is performed outside the body. The embryos that result from the fertilization are then implanted in the uterus of the woman. These embryos are expected to turn into a fetus in the uterus.

There are different techniques used in the process of IVF and Intracytoplasmic Sperm Injection (ICSI) is one of them. ICSI is a specially assisted procedure of fertilization that serves the same purpose as IVF. However, it is different from IVF in terms of the fertilization process.

Generally, with IVF, the sperm and eggs are combined in a dish and the penetration of the egg by the sperm is a natural process. There can, however, be some risk involved with this when the sperm and eggs are underperforming, the fertilization process doesn’t occur properly. There are several factors that come into play for the embryos to be successfully implanted.

In case of ICSI, a glass needle is used for picking a single unit of the sperm, which is then directly injected into the egg in a laboratory. The entire procedure is monitored by embryology experts. Such a process requires a different set of specially crafted equipment.

Contradictory to IVF, there is no need for the eggs to be naturally penetrated in case of ICSI. The machine takes care of the process. Hence, there is a reduction in the use of sperm volume. It also makes sure that successful implantation can be done even with the use of poor-performing eggs. It is worth noting that there is no assurance of the fertilization being successful. After the sperm is placed carefully in the egg, the ordinary fertilization course still needs to take place.

Defining ICSI

ICSI or Intracytoplasmic Sperm Injection is a potent assisted reproductive technology (ART). It is mostly used in severel cases of male infertility. When it comes to modern infertility treatment options, ICSI is the second biggest advancement, with IVF being the first. This is because the process has allowed fertility experts to address the issue of male factor infertility directly. With the ICSI techniques, an individual sperm is directly introduced into the eggs obtained during the IVF process. Pregnancy is initiated after the transfer of the resulting embryo to the uterus. The process has actually proven to be a revolutionary procedure. It gives new hope to several couples who haven’t been able to conceive successfully.

Difference with IVF

From the point of view of a patient, not much difference lies between ICSI and IVF, apart from the cost of the procedures. The difference lies in the procedure of fertilization, with eggs being forcefully penetrated by professionals in case of ICSI. Thus, the entire ICSI process is dependent completely on the woman’s reproductive functionality. The embryos are placed inside the uterus upon successful fertilization. Apart from that, the rest of the process is quite similar to the IVF process itself. Usually, ICSI is chosen as a fertility treatment option when the male’s sperm performs abnormally. Since it is an assisted infertility treatment, the procedure is an elective one.

 Is ICSI right for you?

The answer to that question is completely dependent on your diagnosis. Without an accurate diagnosis, it is not possible to determine whether it is appropriate to opt for ICSI as a treatment for you. That is the obvious way to approach infertility treatment. However, there are couples who deal with infertility thinking they have an idea of what the issue is actually is, despite never being properly diagnosed.

 Steps involved in ICSI procedure – Techniques Used for ICSI

The technique used for performing the procedure of ICSI is known as micromanipulation. With the micromanipulation technique, an inverted microscope is used for enabling embryologists to choose and pick up individual sperms in a special ICSI needle. Then, the needle is carefully put through the egg’s outer shell and egg membrane. The injection of sperm is then done to the cytoplasm (inner part of the egg)

In essence, the ICSI procedure involves 5 basic steps:

  • A specialized pipette is used for holding the mature egg.
  • A single sperm is immobilized and picked up by a very sharp, hollow and delicate needle.
  • The needle is then advanced into the cytoplasm of the egg into the shell of the egg in a careful manner
  • The need is removed carefully after injecting the sperm into the cytoplasm
  • To check whether fertilization has occurred normally, the eggs are inspected the day after the injection.

ICSI prerequisites

The ICSI process can only be performed if the following prerequisites are fulfilled or performed successfully:

  • Serial ovary stimulation to aid in the egg development
  • Retrieval of eggs
  • Implantation of an embryo into the uterine wall.

Why should the ICSI method be used?

Intracytoplasmic Sperm Injection (ICSI) is primarily used in cases of male infertility. There are different types of male infertility, including:

  • Impaired motility or moving ability of the sperm
  • Low sperm count
  • Sperm absence in the ejaculate
  • Abnormal morphology of the sperm, i.e., shape of the sperm

There are rare male infertility cases with which ICSI can turn out to be extremely helpful, including:

  • Issues with the sperm binding to the egg and penetrating it
  • Anti-sperm antibodies. These are protective or immune proteins that attach to sperms and destroy it.
  • Previous failure in fertilization with conventional fertilization methods or IVF culture despite repeated attempts.
  • When the sperm is frozen for collection before cancer treatment, their quality and number might be limited.
  • Sperm can also be absent because of blockage. In that case, the retrieval of sperm is done either from the testis by a process known as TESA (testicular sperm aspiration) or from the epididymis by MESA (microsurgical epididymal sperm aspiration) procedure.

In the cases mentioned above, routine IVF and IUI are not effective enough. The routine procedure of IVF involves production of embryo through mixing of the retrieved eggs with a large quantity of sperm and incubation in culture. Therefore, the success of the process is dependent on the availability of adequate healthy and viable sperm for achieving fertilization, which is not possible for the above-mentioned cases.

Since a single sperm is directly injected into the egg, the procedure of ICSI is a highly-targeted approach of IVF. This approach is useful when the standard methods have failed or are not an option itself.

The ICSI technique is not an effective method for treating female factor infertility, i.e., infertility that results from poor quality of eggs.

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