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 You are here : Home / Fertility / ICSI

ICSI

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  1. Who might benefit?
  2. Is ICSI appropriate for all male fertility problems? How it's done ?
  3. How long will the treatment last?
  4. What's the success rate?
  5. What are the advantages?
  6. What are the disadvantages?


ICSI Treatment India, Cost Intra Cytoplasmic Sperm Injection Treatment, Cost Intra Cytoplasmic Sperm Injection Treatment Mumbai India, ICSI, ICSI Treatment, ICSI Treatment Mumbai Bangalore Delhi India,  Intra Cytoplasmic Sperm Injection Treatment Hospitals, ICSI Surgery Center, ICSI Treatment Clinic, ICSI Surgeons India, Intra Cytoplasmic Sperm Injection Surgery Doctors India, ICSI Surgery Superspeciality Hospital India, ICSI Superspeciality Clinic Goa IndiaICSI (intracytoplasmic sperm injection) is a procedure that can be used as part of an IVF (in vitro fertilisation) treatment. It was introduced in 1992 and was welcomed as a breakthrough in fertility treatment where the problem is on the man's side.

Since then ICSI has become the most successful technique in male infertility treatment, replacing other techniques such as SUZI (subzonal sperm insertion), which gave sperm a head start by injecting them through the outer layer of the egg.

In ICSI only one sperm is needed, which is injected directly into the egg. ICSI is now used in nearly half of all IVF treatments.


Who might benefit?

ICSI can offer real hope to couples where the man has a very low sperm count, produces few good-quality sperm, or has a problem with anti-sperm antibodies in his semen. It can also help couples who would prefer not to use donor sperm, as it gives them a greater chance of success using the man's own sperm.

With ICSI, the sperm do not have to travel to the egg or penetrate the outer layers of the egg. This means that it can help men whose sperm cannot move properly or where the sperm can get to the egg, but are unable to fertilise it for some reason.

It is used to help couples where the man has had an irreversible vasectomy, or has no sperm in his semen due to missing tubes or blockages in his reproductive organs.

Couples who have tried IVF can sometimes move on to ICSI if not enough eggs could be retrieved from the woman, or if few of the eggs retrieved for IVF were successfully fertilised in vitro.


Is ICSI appropriate for all male fertility problems?

There are some male fertility problems for which ICSI may not be the solution. Some men have a low sperm count which, as a result of a genetic problem, could be passed on to any sons conceived via ICSI. A blood test to screen for such problems is often recommended before starting an ICSI cycle. You should be offered counselling before and after taking the test to help you prepare for, and cope with, the results.

How it's done

As with standard IVF treatment, the woman will be given fertility drugs to stimulate her ovaries to develop several mature eggs for fertilisation. (Women normally release only one egg a month.) Once the eggs are ready, the man and the woman undergo separate procedures.

The man may produce a sperm sample himself by masturbating into a cup, but if there is no sperm in his semen, doctors can retrieve sperm from the man. In most cases the sperm is extracted with a needle from a testicle under anaesthetic.

If this doesn't remove enough sperm, the doctor will take a biopsy of testicular tissue, which sometimes has sperm attached. This procedure is called testicular sperm extraction (TESE). It's sometimes done before the treatment cycle begins, and the retrieved sperms are frozen.

After giving the woman a local anaesthetic, the doctor will remove her eggs using a fine, hollow needle. (An ultrasound helps the doctor locate the eggs.) A lab technician then isolates individual sperm and injects them into individual eggs. Two days later the fertilised eggs become balls of cells called embryos.

The procedure then follows the same steps as in IVF. The doctor transplants one or two embryos into the woman's uterus through her cervix using a thin catheter. A maximum of three embryos can be transferred if the woman is over 40 years old and is using her own eggs, one or two if she is using donor eggs. Extra embryos, if there are any, may be frozen in case this cycle isn't successful.

One embryo may attach to the uterine wall and continue to grow. After about two weeks, the woman can take a pregnancy test.


How long will the treatment last?

One cycle of ICSI takes four to six weeks to complete. You and your partner can expect to spend a full day at the clinic for the egg and sperm retrieval procedures. You'll go back two days later for the embryo implantation.


What's the success rate?

The success rate of ICSI is increasing as more and more clinics become experienced in the technique. Many clinics now find that their clinical pregnancy rates for ICSI are higher than those achieved using conventional IVF methods. The national average success rate for ICSI for women aged under 35 years is around 29 per cent.


What are the advantages?

This technique opens doors to parenthood that were previously closed to some couples with a male factor fertility problem. ICSI gives men with a very low sperm count or other fertility problems a chance of conceiving their genetic child.


It is possible to use immature sperm that have been retrieved from the man's testicles so ICSI can be used, for example, to help men who have had a vasectomy that cannot be reversed.

ICSI can also be used to help couples with unexplained infertility, but experts have not found that it makes pregnancy more likely than standard IVF.


What are the disadvantages?

During normal conception, only the hardiest sperm manage to travel great distances and break through the membrane of an egg to fertilise it. Weaker sperm never make it. Because ICSI bypasses this process, critics worry about higher rates of miscarriage, and long-term health and development problems for children conceived using whatever sperm are available.

Research to date has been reassuring about most potential risks. No impact seen so far, for example, on the cognitive and motor skills of children conceived using ICSI. However, there is some evidence of an increased risk of structural abnormalities in ICSI babies.

A large-scale international study found that 4.2 per cent of the ICSI babies had a major malformation, which mainly affected boys' urinary and genital systems. The risk of malformation was almost three times higher in ICSI babies than in babies conceived naturally.

This may go some way to explain why the same study found that children conceived by ICSI and standard IVF were more likely to have had a major childhood illness, medical intervention or surgery by the age of five than children conceived naturally.

Parents of babies born by ICSI also worry about the future fertility of their child, but the technique hasn't been in use for long enough yet to tell whether this will be a major issue for ICSI babies in adulthood.

Much more research is needed before all the risks associated with ICSI can be known. In the meantime, many couples who conceive through this technique have regular ultrasound scans in early pregnancy to monitor the baby's development. If you are at all concerned, talk to your consultant.



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