What is intracytoplasmic sperm injection (ICSI)? ICSI Procedure in India

by Dr. Firuza Parikh

ICSI or Intracytoplasmic sperm injection, is the most common and leading treatment for male fertility issues. This technique is chosen by couples who have faced an unsuccessful fertilization even after IVF treatment. Here a single live sperm is injected directly into the female egg with the help of a glass needle.

During ICSI, the female partner undergoes Ovarian Stimulation through Fertility medications to produce multiple mature eggs. ICSI stands as a powerful solution that addresses male infertility challenges and is a go-to option for low male sperm count cases.

ICSI Procedure in India

Who requires ICSI?

6 out of 10 IVF procedures take place using ICSI. Doctors recommend undergoing ICSI if you are facing the following issues:

Low sperm count in male partners
Unsuccessful egg fertilization in traditional IVF
Poor Sperm Motility and Morphology
Recommended when sperm has DNA damage
Concerns about Genetic and Chromosomal abnormalities
Obstructive Azoospermia
Using frozen/donor sperm for your treatment
Unexplained infertility
The sperm used for fertilization has been recovered through surgical sperm retrieval

Many patients choose to directly undergo ICSI treatment to maximize their success.

If there are any abnormalities observed from the sperm test results, you should seriously consider ICSI. We also recommend ICSI treatment if the male partner has had a vasectomy reversal.

What is the fertilization rate of ICSI treatment?

The fertilization rate of ICSI is 70 to 80% where 7 to 8 out of every 10 eggs get fertilized after injecting the sperm into the female egg.

It is the most common method of fertilization for couples who are facing severe male infertility issues or failed IVF cycles in the past.

What factors affect the success rate of ICSI?

The success rate of ICSI depends on various factors like:

Sperm Quality: The health and quality of the sperm used in ICSI can significantly impact the success rates. Higher quality sperm and better motility and morphology can increase the likelihood of fertilization.

Egg Quality: Healthy and mature eggs retrieved from the female partner have higher chances of fertilizing into viable embryos.

Underlying causes of Infertility: Addressing the causes of infertility such as male infertility, female infertility or even unexplained infertility through appropriate IVF treatments can improve outcomes of pregnancy.

Age of the Woman: Younger women tend to have higher success rates with ICSI and the quality and number of eggs reduces with age.

Lifestyle Choices: Making healthy lifestyle choices such as diet, exercise, adequate rest and abstinence from smoking and alcohol consumption can improve the chances of a successful treatment.

Clinic Expertise: The experience and expertise of the IVF Clinic and its medical team can greatly influence the success rates. At Fertiltree IVF Center our experienced team will guide you and support you through every step of your journey towards parenthood.

Use of Advanced Techniques: Use of advanced techniques such as PGT (Preimplantation Genetic Testing) or Assisted Hatching may be used along with ICSI to improve outcomes.

The First ICSI Baby of India

Luv Singh, who is India’s first baby conceived through ICSI treatment in 1994 by Dr. Firuza Parikh, recently became a father via natural conception at Jaslok Hospital and chose Dr. Firuza Parikh to deliver their baby, completing a full circle of life and marking a significant chapter in the history of assisted reproduction.

Source.

How does ICSI work?

Ovarian Stimulation: The female partner is given medication to boost the development of follicles in the ovary starting usually on Day 2 of menses. The stimulation continues till the follicles are ready with mature eggs.
Egg Retrieval: The hormonal stimulation culminates with egg retrieval. The oocytes are collected under mild anesthesia under transvaginal ultrasound guidance.
Sperm Collection: Once the sample is collected by masturbation, it is handed over to the embryology laboratory where the embryologist processes it in a gentle way to obtain viable and healthy sperm.
Micro-Injection: ICSI is carried out using a joystick, a micromanipulator system, and a microscope. In this procedure, the oocyte is prepared by removing its outer coat of cells called the cumulus complex. Once laid bare, the oocyte is held gently by a holding pipette under an inverted microscope. The sperm that has been prepared for microinjection is injected through a very fine micropipette into the cytoplasm (body) of the oocyte. The oocyte holding pipette and the injection pipette are 20 and 60 times thinner than human hair respectively. The egg itself is no bigger than the tip of a pin. The microinjected egg is returned to the incubator and checked the following day for fertilization.
Culture: After fertilization, the embryos are cultured in the warmth of the incubator for 3 to 5 days.
Embryo Transfer: Once the embryos are ready, usually a single good-quality embryo is transferred into the uterus where it will implant.

What is the cost of ICSI Treatment?

At Jaslok Fertiltree IVF Center we receive patients from all around the globe for ICSI IVF treatment. The cost for ICSI ranges between Rs.1,10,000 to Rs.1,80,000 per cycle depending on several factors such as age, ovarian reserve, use of advanced technology and other add-ons. These costs are exclusive of the medications that range anywhere between Rs.50,000 to Rs.1,50,000 per cycle. IVF treatment costs in India are significantly lesser than the Western countries due to which we are seeing significant inquiries from foreign patients.

Being the pioneers of ICSI, Cumulus Aided Transfer, Artificial Intelligence and Preimplantation Genetic Testing and have one of the highest successful pregnancy rates in India matching global standards. Our dedicated team has successfully delivered over 20,000+ babies and is fully trained and experienced to support you and be a part of your journey towards parenthood.

Additional FAQs

Are there differences in embryo quality or pregnancy rates between ICSI and non-ICSI embryos?

There are possibilities of complete failure of fertilization with IVF but a failed fertilization with ICSI is very rare. Usually there is no significant difference in the quality of the embryos.

Will all of our eggs be injected?

Yes, all mature eggs will be injected with a single sperm each, immature eggs do not fertilize even if the sperm is injected into them.

What are the risks associated with ICSI?

There is some research and articles that do suggest a slight increase in congenital abnormalities in children born with ICSI, however the difference is not significant.

Does ICSI increase your risk of having twins, triplets or more?

While the ICSI treatment does not directly cause twins, it increases the chances for multiple pregnancies. This is because multiple embryos are created in the laboratory and are then transferred to the mother’s uterus to increase the chances of a successful pregnancy. During the process, if more than one embryo implants and develops, it can lead to multiple pregnancies. This phenomenon is affected by multiple factors such as the woman’s age, quality of sperm, quality of embryos and most importantly the number of embryos transferred.

How is ICSI different from IVF?

In IVF, multiple sperm are added to the dish containing the female egg for natural sperm penetration for fertilization whereas ICSI is an advanced form of treatment where a single sperm is injected into the female egg using a glass needle which increases the chances of the egg getting fertilized. ICSI is recommended for patients with severe male factor infertility.