Assisted reproductive technologies (ART) is a lab-based treatment that fertilises sperm and eggs outside of the human body for conception. In the last 50 years, IVF technology is by far the most common ART procedure performed along with intracytoplasmic sperm injection. Both ICSI and IVF are used to treat infertility. ICSI has been shown to improve fertilisation rates for patients with male factor infertility or past conception failures. ICSI treatment is a procedure that directly injects a sperm into the oocyte, through the cytoplasm.
This is a specialised type of assisted reproductive technology procedure known as Intracytoplasmic sperm injection (ICSI). During the procedure, a sperm is placed into a woman's egg with a needle in a clinical or a lab setting. A sperm cell is directly injected into the egg or oocyte’s cytoplasm to develop an embryo or a fertilised egg. The procedure is a type of IVF.
Usually, doctors use the ICSI treatment along with IVF and the next day, the doctor checks to see if the egg is fertilised. The fertilised eggs are observed carefully as they develop over the following days until they become embryos with multiple cells. These embryos are then placed into the woman's uterus by the doctor.
Most embryo transfers are now Frozen Embryo Transfers. This means that the embryos can be re-frozen and later thawed before transfer. The step enables more control over the timeline and can lead to higher success rates than a direct embryo transfer. This way, aspiring parents can freeze and store any remaining best-quality embryos for future use and sibling journeys.
Intracytoplasmic sperm injection is the most common and successful treatment for male infertility. ICSI is recommended in the following cases when:
When in vitro fertilisation (IVF) is used with intracytoplasmic sperm injection, the procedure allows otherwise sterile couples to become parents. ICSI treatment follows these steps:
Ovarian Stimulation: Medications are used to stimulate the ovaries for about 8 to 14 days to produce many mature eggs, increasing the chances of success.
Egg Retrieval: A doctor performs the procedure to collect eggs from the ovaries. The eggs are combined with the collected sperm for fertilisation.
Fertilisation: The embryologist injects the best quality sperm into each mature egg under a microscope.
Embryo Development: After fertilisation, embryos are monitored and allowed to develop for 3 to 5 days , aiming for high-quality embryos.
Embryo Transfer: The selected embryos are transferred into the woman's uterus, a simple procedure lasting about 5 minutes.
Pregnancy Test: Two weeks after the embryo transfer, a pregnancy test is done to check for pregnancy.
The primary advantage of the ART treatment like intracytoplasmic sperm injection during IVF (IVF ICSI) is an enhanced fertilisation rate, which can increase the number of fertilised eggs available for transfer or freezing. For couples struggling with male factor infertility, ICSI treatment can boost your chances for a successful fertilisation under standard insemination such as IUI. ICSI is effective for those looking to increase their high-quality embryos created from one egg retrieval. Men who don’t have issues with sperm development, sperm count, or sperm motility can still benefit from ICSI. Also, couples with failed previous IVF attempts may benefit from ICSI treatment. Additionally, couples who want to test for certain genetic problems often make good candidates for ICSI treatment.
Before ICSI treatment can begin, the fertility team collects the sperm and eggs. The egg retrieval process entails ovulation induction, where medication injections stimulate the ovaries, which results in mature eggs. At this stage, Transvaginal ultrasound technology is used to guide a needle into the ovaries to collect the eggs, with mild anaesthesia to ensure that the patient is comfortable. Also, the sperm collected is analysed for mobility, volume, and quality. In certain cases, procedures like microscopic testicular sperm extraction or electroejaculation may be necessary, and the sperm can be frozen and stored for future use in IVF.
The price of ICSI fertility treatment typically starts at Rs 1,50,000, but it may vary depending on the fertility hospital you choose. In general, ICSI treatment in tier I cities is more expensive than in tier II and III cities for infertility treatment.