ICSI Intracytoplasmic Sperm Injection

ICSI (Intracytoplasmic Sperm Injection)

ICSI, In vitro fertilization treatment, technological and medical developments are used together in order to achieve success. As a result, 80% of infertility problems have reached a level where they can be solved with in vitro fertilization methods. The microinjection method is also a very important technique for in vitro fertilization treatment that increases the chance of success. Microinjection is applied during the fertilization stage within the scope of in vitro fertilization treatment. If it is decided to use the microinjection method, the sperm and egg cells taken from the prospective mother and father are fertilized with the microinjection method.

After this stage, the in vitro fertilization stages are carried out in the same way. In the classical in vitro fertilization method, namely the IVF method, sperm cells are placed around the egg cell taken. One of these sperms fertilizes the egg and thus an embryo is formed. However, in the microinjection method, a single sperm cell taken is injected into the egg cell. In this way, fertilization can be achieved with a higher success rate. It is considered revolutionary, especially in severe male infertility.

What is Microinjection ICSI? What is the difference between the classical IVF and IVF?

In the classical IVF method, many sperm cells are placed around the highest quality egg cell. The highest quality of these sperm fertilizes this egg cell on its own. The fertilization that occurs at this stage is the same as fertilization that occurs naturally, only performed in a laboratory environment. In the ICSI, or microinjection method, the selected highest quality sperm cell is injected into the egg cell. In this way, fertilization is achieved thanks to experts. Apart from this, the treatment stages are the same in both methods.

For people experiencing infertility, intracytoplasmic sperm injection (ICSI) can lead to a successful pregnancy. This type of IVF is most useful when there are male infertility problems. Your doctor injects sperm into an egg to help get pregnant. Pregnancy can occur after embryo transfer.

Mikroenjeksiyon ICSI

ICSI is a type of IVF. In traditional IVF, your doctor places thousands of sperm next to an egg in a laboratory dish. Whether one of the sperm gets through to fertilize the egg is a matter of chance. If none of the sperm fertilizes the egg, conception (also called fertilization) does not occur.

ICSI promotes fertilization by injecting a single sperm directly into a single egg. However, ICSI does not guarantee fertilization. In both ICSI and traditional IVF, your doctor places the fertilized egg (embryo) in your uterus. If the embryo attaches to the lining of your uterus, pregnancy occurs.

What is the advantage of the microinjection ICSI method?

The microinjection method is a method with a higher chance of fertilization. It has a higher chance of success than classic in vitro fertilization treatment, especially for men with low sperm count and quality. In the microinjection method, even a male candidate who can take a single sperm cell has a chance of becoming a father. Especially in cases such as azoospermia, the chance of pregnancy is preserved even with the removal of a sperm cell from the testicle.

What happens before ICSI?

Before ICSI can be performed, your healthcare provider will collect the eggs and sperm.

The egg retrieval process involves the following steps:

• Ovulation induction (also known as ovarian stimulation): The person providing the eggs will receive medication injections for eight to 14 days. This stimulates your ovaries to produce multiple eggs at once to mature. Then, an injection of Lupron or human chorionic gonadotropin (hCG) will help the eggs mature eventually.
• Egg retrieval: Your healthcare provider will use transvaginal ultrasound technology to guide the insertion of a thin needle through the wall of your vagina into your ovaries. This step is done with light anesthesia, so there is no pain. A suction device attached to the needle will pull out and collect the eggs.

Unless you are using frozen sperm, sperm retrieval will occur the same day as egg retrieval. The person providing the sperm should:

• Avoid sexual intercourse and masturbation (not ejaculate) for two to three days before sperm collection.
• Masturbate at home or in a private room at a fertility clinic, collecting the ejaculate in a container provided by the laboratory. The sample should reach the laboratory within 60 minutes of ejaculation.

A semen analysis is performed immediately to check sperm volume, motility, and quality. People with azoospermia, anejaculation, or retrograde ejaculation may need a procedure to collect sperm. This also applies to people who have had a failed vasectomy reversal. Procedures such as electroejaculation and microscopic testicular sperm extraction can be performed in a hospital rather than a fertility clinic. A laboratory can freeze and store the sperm for later IVF use in the clinic (sperm banking).

How is Microinjection ICSI performed?

ICSI, the highest quality sperm cell is selected. The tail of the sperm cell is prepared so that it can be retrieved with a syringe. At this stage, the sperm is not harmed in any way. Then, with a very meticulous and expert procedure, it is transferred into the egg cell. Then, when fertilization occurs, the embryos are taken to the laboratory and preserved until the transfer stage to the mother’s uterus.

Mikroenjeksiyon ICSI

In which patients is the microinjection ICSI method applied?

• In prospective fathers with insufficient sperm count,
• In patients with azoospermia,
• In patients who can only obtain sperm cells with the Micro TESE method,
• In patients with severe (more than 95%) sperm shape and morphology disorders,
• In patients whose infertility is due to antisperm,
• In patients who have not been successful in classical in vitro fertilization treatment,
• In patients who need preimplantation genetic diagnosis (PGD),
• In cases of unexplained infertility problems, microinjection is recommended.

Who needs microinjection ICSI?

ICSI is most beneficial for people with male infertility. Your healthcare provider may recommend ICSI if a person has:

• Anejaculation (inability to ejaculate).
• A blockage in the male reproductive system.
• A low sperm count.
• A poor quality sperm.
• Retrograde ejaculation (semen flows back into the bladder).

You may also need ICSI if:

• Traditional IVF has not resulted in the creation of embryos.
• The person providing the eggs is over 35.
• You are using previously frozen eggs or sperm (cryopreservation) to try to conceive.

What happens during intracytoplasmic sperm injection?

During ICSI, your doctor:

• Uses a pipette (a small glass tube with a vacuum) to hold the mature egg in place in a laboratory dish.
• Using a thin needle, a sperm is immobilized and removed.
• Inserts the needle into the egg to reach the cytoplasm of the egg.
• Injects the sperm into the cytoplasm.
• Removes the needle from the egg.

Does fertilization definitely occur with microinjection ICSI?

Microinjection ICSI, No assisted reproductive method has a 100% chance of success. Although the chance of success in the microinjection method is higher than in classical in vitro fertilization treatment, there is always a risk of not fertilizing since the chance of success is not 100%. The chance of fertilization depends on the quality of the sperm and egg cell. Therefore, although methods such as IMSI can be applied to choose the highest quality sperm cell, fertilization may not occur if the sperm cell is of very poor quality.

What happens after microinjection ICSI?

After microinjection ICSI, your doctor monitors the fertilized egg in the laboratory for signs of successful fertilization. Within five to six days, a healthy fertilized egg should divide into cells and form a blastocyst. Your doctor will evaluate the size and cell mass of the blastocyst to determine when it is most likely to lead to pregnancy.

Embryo transfer occurs on the fifth or sixth day following the egg collection procedure, or the transfer is usually delayed for a month or even years. Your doctor will discuss the timing of your embryo transfer with you. Using ultrasound technology, your doctor will insert a catheter (a long, thin tube) into your vagina and inject the embryo into your uterus. For pregnancy to occur, the embryo must implant (attach) in your uterus. Your doctor may recommend waiting at least two weeks before taking a pregnancy test.

What is the chance of pregnancy in those who have microinjection?

In the microinjection ICSI method, pregnancy rates are higher than in classical IVF treatment. However, in this method, the most important factors affecting the chance of success are the age of the mother and the number of ovaries. Although it may vary depending on the age of the mother, the chance of success can be said to be between 50-80%.

What is the price and cost of Microinjection ICSI?

The cost of microinjection application in Microinjection ICSI, IVF treatment is almost the same as IVF treatment. The price and cost may vary depending on the IVF center and the methods to be applied by the gynecologist.

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