ICSI

🧠 Why is ICSI Done?

ICSI is usually recommended in the following situations:

👨‍⚕️ Male Factor Infertility:

• Low sperm count (oligospermia)

• Poor sperm motility (asthenospermia)

• Abnormal sperm morphology (teratospermia)

• Obstructive azoospermia (sperm retrieved surgically from testicles)

• Previous IVF cycle with poor fertilization

• Use of frozen sperm or testicular sperm (TESA/PESA)

• Antisperm antibodies affecting fertilization

• Retrograde ejaculation or spinal cord injuries
  
  

Step-by-Step Process of ICSI

1. Ovarian Stimulation (Same as IVF)

• Female partner receives hormone injections to produce multiple eggs.

• Progress is monitored with blood tests and ultrasounds.

2. Egg Retrieval (Ovum Pick-Up)

• Mature eggs are collected via a minor procedure under sedation.

• Eggs are evaluated under a microscope for maturity.

3. Sperm Collection & Preparation

• A semen sample is provided or sperm is retrieved surgically (e.g., TESA).

• Sperm is washed and processed to select the healthiest, most motile ones.

4. ICSI Procedure

• A single, healthy sperm is immobilized.

• Using a microneedle, the sperm is injected directly into the cytoplasm of the egg under a high-powered microscope.

• Performed by a highly trained embryologist.

5. Fertilization & Embryo Culture

• Eggs are checked the next day for signs of fertilization (presence of two pronuclei).

• Fertilized eggs are cultured for 3–5 days to develop into embryos or blastocysts.

6. Embryo Transfer

• One or more high-quality embryos are transferred to the uterus.

• Remaining embryos can be frozen (cryopreservation).

7. Pregnancy Test

• Blood test (β-hCG) is done 10–14 days after embryo transfer to confirm pregnancy.

📈 Success Rate of ICSI

• Fertilization rate: 70–85% of mature eggs typically fertilize.

• Pregnancy rates: Similar to IVF, but ICSI may improve outcomes in male infertility.

• Success also depends on egg quality, uterine health, and age of the female partner.

⚖️ ICSI vs. IVF: Key Differences

🧪 ICSI with Advanced Add-ons

• Time-lapse embryo monitoring

• Assisted hatching

• Preimplantation genetic testing (PGT-A / PGT-M)

• Embryo glue for implantation support

💡 Important Points to Know

• ICSI is safe and effective, with minimal risk of damage to eggs.

• No increased risk of birth defects, as confirmed by long-term studies.

• Often used in combination with frozen embryo transfer (FET) for better implantation.