1. What is ICSI?
IVF is Intra Cytoplasmic Sperm Injection. Fertilization is meeting of the egg and sperm to form the embryo. When this is done outside the body, by injecting a selected sperm into the egg, in couples who fail to conceive the natural way, it is called Intracytoplasmic sperm injection.
2. For whom is it recommended?
ICSI is recommended in patients with
Bilateral tubal block
Decreased egg number
Grade 3 endometriosis
Severe male factor (very less count or sperm motility)
Zero sperm count opting for testicular sperm retrieval
Repeated IUI failures
Recurrent abortions opting for Pre Implantation Genetic Testing
Donor oocyte programme
3. How is it done?
Day 2 wife undergoes scan and Hormone tests
Injections given for all the follicles in her ovary to grow for around 10 days on an average (controlled ovarian stimulation)
Trigger injection is given for final maturation of eggs when almost all follicles are around 18 mm
Egg pick up is done around 35 hours after trigger
IVF/ICSI is done and eggs are fertilized in the lab
Embryo growth is assessed and transferred or frozen on day 3 or day 5 post egg pick up
Pregnancy test is done 13/15 (in day5/day3 transfer respectively) days after transfer
In case embryos are frozen, in the next cycle, lining of the uterus is prepared and embryos are thawed and transferred.
4. Is it painful?
As compared to previously used drugs, the currently available injections are less painful. Egg pick up is done under anaesthesia and pain is not felt by the patient. Embryo transfer requires no anaesthesia and a transfer done with minimal manipulation and absolutely no pain is most fruitful.
5. What are the chances of pregnancy with ICSI?
The success rate of ICSI depends on the couples age and cause for subfertility.
6. What is the difference between IVF and ICSI?
IVF involves incubating each egg we retrieve with few sperms and allowing a sperm to get naturally selected to fertilize the egg.
ICSI is Intracytoplasmic Sperm Injection wherein the best sperm is selected from the sample and is injected into the egg retrieved.
They are different ways of getting the egg fertilized and which process is chosen over the other is individualized by the clinician for each couple
7. Are there any side effects associated with ICSI?
Presently used medications and the process of ICSI is extremely safe with no/minimal side effects
8. Is there a chance of twin/multiple pregnancy with ICSI?
In the era of elective single embryo transfer, the chances of twin/multiple pregnancy is nil. But of course, if more than 1 embryo is transferred then the chances of multiple pregnancy obviously increases
9. Is bed rest recommended after ICSI?
Bed rest is not recommended after ICSI.
10. What precautions need to be taken after embryo transfer?
Healthy, home cooked, protein and fibre rich food
Small, frequent meals, adequate amount of water
Stress free lifestyle, meditation can be practised
No bed rest
Intercourse need not be restricted
Travelling long distance may be avoided
Taking the stairs may be allowed
Positive attitude is most important
11. What are the reasons for failure of ICSI?
A good embryo and a receptive endometrium are the key to a successful IVF cycle
Failure at any point, the following should be considered:
Age of the couple
Number of eggs, morphology of the eggs
Number of embryos formed and the grade of embryos
Endometrial thickness and vascularity
Despite everything being good, if a cycle fails, patience and persistence for a second attempt definitely helps