For generations, there was little that doctor could do to help infertile couples especially where male factor was involved (disorders of sperm production). However in the last few years there has been major break-through in the treatment of male subfertility in the form of Intra cytoplasmic sperm injection (ICSI). Till recently solution of stubborn cases of male subfertility was adoption, now thay can be treated successfully by this method.

- WHAT IS ICSI?

ICSI is very similar to conventional IVF in that gametes (eggs and sperm) are collected from each partner. The difference between the two procedures is the method of achieving fertilization.

In conventional IVF, the eggs and sperm are mixed together in a dish and the sperm fertilizes the egg ‘naturally’. However to have a chance that this will occur, large numbers of actively swimming normal sperm are required. For many couples, the number of suitable sperm available may be very limited or there may be other factors preventing fertilization, so conventional IVF is not an option. ICSI has provided a hope for these couples.

ICSI refers to the laboratory procedure where a single sperm is picked up with a fine glass needle and is injected directly into each egg .This is carried out in the laboratory by experienced embryologists using specialist equipment. Very few sperm are required and the ability of the sperm to penetrate the egg is no longer important as this has been assisted by the ICSI technique. ICSI does not guarantee that fertilization will occur as the normal cellular events of fertilization still need to occur once the sperm has been placed in the egg.

- INDICATIONS

From a patient perspective, undergoing an ICSI treatment cycle is exactly the same as a conventional IVF cycle, and the same steps are involved.
Circumstances in which ICSI may be appropriate include:

• Severe Oligo Astheneo Teratozoerpmi 
• Azoospermia via MESA, PESA &  in more severe forms TESE
• high levels of antibodies in the semen
• Repeated fertilisation failure using conventional IVF.
• Retrograde Ejaculation .

- WHAT ARE THE CHANCES OF SUCCESS?

Chance of success are about 40% however in any given couple chances of success depend upon various factors among which quality of semen and egg of wife are important examples. The success rate of ICSI/IVF seems to be low but one should bear in mind that in absolutely normal couples the possibility of achieving a pregnancy in any given cycle is one in six to one in nine.

- HOW MANY ATTEMPTS OF ICSI/IVF CAN BE MADE?

From medical point of view there in no limit on the number of attempts but one has to take into consideration emotional and financial stress involved in this treatment.

- STEP BY STEP ICSI

• Preliminary check up of husband & wife
• Baseline hormone levels of wife
• Drug treatment (injections) to encourage egg production & maturation
• Ultra sound monitoring of treatment
  • To measure the growths of follicles
  • To adjust dose of drugs
  • Prevent serious side effects (ovarian hyper stimulation syndrome)
• Monitoring is carried out:
  • By trans-vaginal ultrasound scanning (TVS)
  • By measuring hormones in blood
• Egg pick up
• Semen collection & processing.
• ICSI:- single spermatozoa (male germs) is injected into the egg under special (ICSI) microscope with micromanipualotor. Egg collection, semen processing & sperm (male germs) injection is performed on the same day
• Injected eggs are incubated in culture medium under special environment (Incubator)
• Embryo transfer. After two to three days of spermatozoa (male germs) injection
  if fertilization takes place then 2–3 fertilized eggs (embryos) are transferred into the uterus (womb). This procedure normally does not need any anaesthesia or sedation

- USE OF DONOR’ S SPERM

We strictly use husband’s spermatozoa (male germs) and wife’s egg. Donor’s spermatozoa (male germs), egg and surrogacy facilites are not available in our clinic.