Microinjection method

What is ICSI?

ICSI, with the full name "Intracytoplasmic Sperm Injection," is one of the newest assisted reproductive methods (ART) used by IVF technology. This method is used when the male sperm does not have enough speed and strength to reach and enter the egg. In this case, they must be fertilized in the laboratory after receiving samples of male sperm and female eggs. In other words, it can be said that the ICSI method is more beneficial for couples with sperm problems, But in the IVF method, the most significant focus is on fertilizing the egg.

ICSI use cases

In treating severe infertility and failure of other assisted reproductive methods, ICSI is suggested and used in case of a man's lack of sperm or inability to produce sperm. In general, the conditions that trigger the use of the ICSI method are:

• Low sperm count in men
• No sperm in the semen sample
• Improper and abnormal morphology of sperm
• Decreased sperm motility
• A history of past vasectomy and need to remove the epididymis or testicles
• Injury or absence of the vas deferens in men
• Creating problems and failure of artificial insemination in previous treatment
• Non-obstructive azoospermia (presence of sperm in testicular tissue but absence of sperm in semen)
• Diabetic ejaculation disorders, spinal cord injury, etc.
• You need to use frozen sperm
• The low number of eggs taken from the woman
• The presence of some genetic disorders

What are the steps of ICSI?

When infertility problems occur, after visiting the specialist doctor and consulting the couple, routine examinations and some hormonal examinations are prescribed. If recommended according to the test results, ICSI or ICSI measures must be taken before the operation. The steps for ICSI are as follows:

• Ultrasound and ovulation stimulation: Ultrasound is performed on the second or third day of menstruation to check the condition of the uterus and ovaries, and if necessary, ovulation-stimulating medication (oral or injectable) is used. The doctor for 10 to 14 days to allow the follicles to be transferred, and the embryo laboratory environment must be provided during the puncture (ovulation) process. The egg can be extracted from these follicles in the following steps. Of course, it should be noted that 5 or 6 ultrasounds will be done while using stimulant drugs - depending on the amount and type of reaction of the ovaries to the drug.
• Collecting eggs: After sufficient growth, the eggs are examined in terms of their maturity, appearance, and health. After puncturing the enlarged ovaries, an HCG injection is performed under general or local anesthesia. At the same time, a sample of male semen is taken and received to be sent to a laboratory. Embryos.
• Sperm collection: In this step, the semen and sperm are examined under a microscope to identify and separate active and healthy sperm in terms of appearance and movement. After the healthy sperms have been completely separated, the sperm-washing process is done so that the sperms are ready for injection into the cytoplasm of the eggs removed from the follicles.
• In Vitro Fertilization: About 36 hours after the HCG injection, in vitro fertilization takes place, and the egg cell is placed in the incubator to reach the four or 8-cell stage. It is worth noting that the stage of fertilization and injection in the ICSI or ICSI method is a sensitive stage that takes place with the latest technology in the world. At this stage, by separating the cells around the egg with special enzymes, sperm are injected into it with special microscopic needles, and after 24 hours, they are examined. If fertilization progresses appropriately, this period continues until the cell is ready for transfer to the uterus. Sometimes, due to many embryos formed, some can be frozen for future pregnancy or donated to other couples if desired.
• Embryo transfer: Embryo transfer must occur at a point with the maximum potential for implantation. For this purpose, within 72 hours after in vitro fertilization, laparoscopic or vaginal ultrasound methods are used to transfer up to 3 or 4 embryos with faster growth and better quality to the uterus through a catheter (narrow and flexible laboratory tube). It must be said that usually, for embryo transfer, the transvaginal catheter injection method is chosen and does not require anesthesia. Still, sometimes, due to some problems, the doctor decides that arthroscopic surgery is a more suitable option. During this process, called ZIFT, the doctor can transfer several embryos into the uterus depending on the woman's age, the condition of the uterus, and the quality of the embryos. Then, about two hours after the injection of the fetus and after the mother is discharged, she is recommended to rest at home for a few days.
• Pregnancy Test: About two weeks after the sperm is placed in the mother's uterus, a pregnancy test is taken from the woman to confirm that pregnancy has occurred.

The stage of fertilization and injection in the ICSI method

The stage of fertilization and injection in the ICSI method is a sensitive stage performed with the latest technology in the world. At this stage, by separating the cells around the egg with special enzymes, sperm are injected into it with special microscopic needles, and after 24 hours, they are examined. If fertilization progresses appropriately, this period continues until the cell is ready for transfer to the uterus. Sometimes, due to many embryos formed, some can be frozen for future pregnancy or donated to other couples if desired.

What is the success rate of ICSI?

The success rate of assisted reproductive methods is variable. It depends on various reasons and conditions, such as the woman's age, the condition of the sperm and egg, the cause of infertility, the health status of the fetus formed, and the woman's health: reproductive system, laboratory conditions, and physical skills. The success rate will differ according to these conditions and reasons each time this process is performed.

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