ICSI or Intracytoplasmic Sperm Injection

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ICSI: aka Intracytoplasmic Sperm Injection, Intracytoplasmic Sperm Injection for Infertility


What is it?


Intracytoplasmic sperm injection or ICSI is a procedure where lab specialists inject sperm into the mid point of an egg. These days assisted reproductive technology is getting more sophisticated than ever, working to provide infertile couples the best possible tools to help them conceive and carry a child to delivery.


ICSI is an effective tool for fertilizing eggs for assisted reproductive technologies like in vitro fertilization. Normally ICSI goes hand-in-hand with in vitro fertilization or IVF procedures. In vitro fertilization requires the use of an ICSI fertilized egg to inject into a woman’s cervix or uterus in an attempt to get her pregnant.


Laboratory specialists use many different tools when attempting to fertilize an egg including inverted microscopes that allow specialists to hand pick sperm and specially designed needles that are hollow to allow them to select or hand pick sperm.


The Operation


Typically ICSI is for couples that have tried IVF unsuccessfully or for those couples that may be candidates for IVF but not without a bit of help in the fertilization area.


If you need help with fertilization ICSI can dramatically help increase the odds of a successful IVF course. During the procedure scientists select individual sperm from a petrie dish using a hollow ICSI specialized sterile needle. The needle once it contains the proper sperm is then pushed through the outer exterior of the female egg and egg membrane. Once this happens the sperm is then injected into the heart or cytoplasm of the egg. Typically in up to 85 percent of all eggs this will result in fertilization provided there is nothing wrong with the donor sperm.


The woman donor usually has to be first stimulated using various hormonal medications. She will also undergo an egg retrieval process. Usually this process involves the use of more than one egg and more than one sperm to ensure as many eggs and sperm (usually up to 4) are fertilized when possible and used during the process.


Alternatives to Surgery


There are many other processes aside from the IVF process. Many times the ICSI process is only used if male factor infertility, meaning the infertility issue is related to a male factor problem comes into play. However, most of the time both male factor and female factors come into play in complex fertility cases.


When trying to help couples conceive a child it is most prudent to consider all possible causes, at least that is the general consensus among many doctors and researchers nowadays. This is one reason ICSI is gaining popularity.


Before the Operation


Prior to the procedure women will undergo treatment with many different medications to encourage the release of several eggs which are harvested for fertilization. Men will then provide a sample from which several sperm are selected and then placed into the eggs for fertilization.  


After the Operation- At Home


Following the procedure the egg may then undergo another process like assisted hatching, or the egg may be directly implanted into the woman in an intrauterine insemination IUI process or similar process.


Possible Complications


Generally with ICSI there are few if any complications for the male. The male has to provide a sample. There may be some complications that are psychological in nature including the pressures associated with providing an effective sample that will produce a viable sample for collection.


A female taking medication to produce a viable egg will undergo similar challenges and potential side effects associated with taking medications to stimulate fertility and egg production.


General Advice


ICSI is a procedure that can help couples facing infertility increase their odds of producing a viable fertilized egg for purposes of in vitro fertilization. Couples most likely to benefit from ICSI with IVF include:


  • Couples experiencing male factor infertility
  • Couples that have low sperm motility
  • Couples that have tried unsuccessfully at in vitro fertilization in the past
  • Couples that have had trouble producing eggs for IVF in the past and want to ensure fertilization of the eggs they do produce
  • Older couples interested in assuring fertilization
  • Poor sperm morphology or composition


Success rates with ICSI tend to be generally very high, up to 85 percent with proper procedure and technique, although these rates will vary from couple to couple.


Estimated Costs for An ICSI


The cost of ICSI will vary from individual to individual. Some hospitals will tack on the charge of IVF with the cost of ICSI for a single procedure, so be sure to ask whether the cost includes IVF with ICSI or if the cost is just for ICSI with associated medical and medication expenses when consulting about this procedure for you and your family.


Many hospitals provide treatment plans that include a full package including treatment for ICSI, IVF and follow up care including medication, counseling and prenatal care. This may or may not work for you depending if you are getting or receiving your care overseas and depending on how far you live from the clinic where you plan to receive care. You may be able to negotiate some or all of your expenses.


Country Costs ICSI
USA $1200-10000
India $500
Malaysia $700
Singapore $600-900
Thailand $500

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