ICSI Procedure
- ICSI is performed a few hours after oocyte retrieval when the oocytes are at the proper stage of maturation for fertilization
- On the day of oocyte retrieval, a sperm sample is collected and processed to produce a clean preparation of viable sperms
- Prior to the ICSI procedure the granulosa cells that surround the oocyte are removed in the IVF laboratory and the mature (MII) oocytes are then selected for ICSI
- Shortly after oocyte retrieval, the embryologist selects a single sperm from the preparation using a microscopic pipette. The pipette has a needle like tip that is used to pierce the egg’s membrane
- A small amount of egg cytoplasm is aspirated into the micropipette allowing the sperm to mix with the cytoplasmic material. The cytoplasm, now containing the sperm, is replaced into the oocyte
- This procedure requires the use of micromanipulator that allows fine control of microscopic movements of the micropipettes. In Corion Clinic, we have RI Integra Micromanipulator from UK which we use for our ICSI procedures
- Immediately after ICSI is performed, each oocyte is returned to the incubator for about 18-20 hours. The next day, the embryologist inspects the oocytes and determines which have fertilized successfully
- The normally fertilized egg also known as “zygote or embryo”, is identified by the appearance of two round structures called “pronuclei” in it’s cytoplasm in addition to two polar bodies on it’s periphery
- The success with ICSI depends largely on the ability and skill of the embryologist performing the procedure; the risks from egg micromanipulation include trauma to the oocyte leading to non-viability (death of the oocyte), or other unanticipated / unidentified risks
- This trauma can occur during the enzymatic removal of the granulosa cells or the ICSI procedure itself
- ICSI does not guarantee fertilization of an oocyte. However, the probability of fertilization of any oocyte with ICSI is 10-15% greater than for oocytes inseminated conventionally with normal sperm
Testicular Sperm Aspiration (TESA) and ICSI
- ICSI has been of tremendous help in the treatment of severe male factor infertility. With ICSI, normal fertilization can be achieved by injecting a single sperm through micromanipulation right into the mature egg
- Additionally some of the steps occurring during natural fertilization are bypassed since the sperm is placed into the egg
- In some isolated cases of very severe male factor infertility or in combination with other female factors, optimal or absent fertilization may be seen even with ICSI
- Once the sperm enters the oocyte, it must communicate with the oocyte to initiate the process of fertilization and embryo formation; in some men the possibility exists that the sperm are unable to perform this function and fertilization does not occur after ICSI
Who might benefit?
- ICSI is generally indicated in couples where sperms are deficient in number or function
- ICSI can also be successful in men with history of a vasectomy, congenital absence of the vas deferens (CAVD), or non-obstructive Azoospermia
- ICSI is also beneficial where abnormal oocytes are retrieved which may not allow sperm to penetrate the zona pellucida
- Couples who have history of suboptimal fertilization rates with conventional IVF
- Couples with high rates of abnormal fertilization in previous cycles
To avail of our ICSI program kindly write to us at reachus@corionfertilityclinic.com
