what is icsi with ivf?
Infertility has been a problem for ages now, but it has only recently started to be spoken about. With more and more talk on infertility, more and more methods of dealing with issues related to infertility are surfacing. The most well-known form of assisted artificial reproduction is IVF. However, many other methods are also rising now, which also have a better success rate like IVF. One of the most popular methods among these is ICSI. It is commonly referred to as ICSI-IVF Treatment since it is not completely detached from IVF; it only includes some more steps than IVF.
ICSI stands for intracytoplasmic sperm injection. The process essentially works as the semen is retrieved from the male, the best sperm selected from it, and then artificially injected into the egg for fertilization. It is one of the most successful methods of artificial treatment for problems related to infertility.
The success rate for ICSI can range from 80 to 85%. This is to say that about eight out of ten eggs will fertilize normally.
Book an Appointment with Fertility Specialist Dr. Uma Maheshwari.
ICSI is suggested under the following circumstances:
ICSI treatment is divided into five main steps;
A single cycle of ICSI treatment may cost you between 2.1 to 2.6 lakh INR. This includes the cost of injections used to stimulate the multiple egg development, Cost of the procedure done in the embryology lab and Freezing of excess good quality embryos.
The top-rated fertility hospitals in India use top-of-the-line equipment, therefore, ICSI treatments at these hospitals yield a higher success rate, although the pocket pinch will be on the higher side.
Description Intracytoplasmic sperm injection is an in vitro fertilization procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. This technique is used in order to prepare the gametes for the obtention of embryos that may be transferred to a maternal uterus. Wikipedia
The information on this page is a general overview of 2 types of assisted reproductive treatment (ART):
More detailed information is available on the Victorian Assisted Reproductive Treatment Authority (VARTA)External Link website.
IVF and ICSI are forms of assisted reproductive treatment (ART) in which eggs are fertilised with sperm outside the body.
IVF is used for female infertility and unexplained infertility, and ICSI is used when there is a male cause of infertility.
Sometimes ICSI is offered when there is no male cause of infertility, but research shows that this does not increase the chance of having a baby.
The steps involved in IVF and ICSI treatment are:
Clinics report success ratesExternal Link in different ways. When comparing clinics’ success rates for IVF and ICSI make sure you compare like with like, or ‘apples with apples’. And, most importantly, you need to consider your own personal circumstances and medical history when you estimate your chance of having a baby with IVF or ICSI.
The woman’s age is the most important factor determining the chance of having a baby with IVF. See what the chance of having a baby is after one, 2, and 3 IVF or ICSI cycles for women of different agesExternal Link .
In the hands of experts, IVF and ICSI are safe procedures and medical complications are rare. But, as with all medical procedures, there are some possible health effects to consider for women and men undergoing treatment and for children born as a result of treatment.
Risks associated with IVF and ICSI include:
IVF and ICSI are also psychologically demanding and emotional health effectsExternal Link are common. In Australia, counselling services are available in all fertility clinics. Women who have IVF treatment, and their partners, are encouraged to use these if they experience emotional difficulties.
In Australia, Medicare (and private health insurance ) covers some of the costs associated with IVFExternal Link and ICSI but there are also substantial out-of-pocket costs.
The difference between the Medicare benefit and the amount charged by the clinic is the out-of-pocket cost. These costs vary, depending on the treatment, the clinic and whether a patient has reached the Medicare Safety Net thresholdExternal Link .
Sometimes people have embryos in storage that they don’t intend to use. Most commonly this is because they have completed their family, but for some people, health reasons prevent them from using their stored embryos. At the end of the storage time limit, which in Victoria is 5 years, people need to decide what to do with unused embryos.
There are 4 options available:
Couples who have frozen embryos that they are not intending to use often find it difficult to decide what to do with them. Victorian Assisted Reproductive Treatment Authority (VARTA) has an interactive decision-making toolExternal Link designed to help people who find it hard to decide what to do with their unused embryos.
What is ICSI?
Intracytoplasmic sperm injection, or ICSI, involves injecting a single live sperm directly into the center of a human egg. The technique was developed to help achieve fertilization for couples with severe male factor infertility or couples who have had failure to fertilize in a previous in vitro fertilization (IVF) attempt. The procedure overcomes many of the barriers to fertilization and allows couples with little hope of achieving successful pregnancy to obtain fertilized embryos.
The procedure requires that the female partner undergo ovarian stimulation with fertility medications so that several mature eggs develop. These eggs are then aspirated through the vagina using vaginal ultrasound, and incubated under precise conditions in the embryology laboratory. The semen sample is prepared by centrifuging, or spinning the sperm cells through a special medium. This separates live sperm from debris and most of the dead sperm. The embryologist then picks up the single live sperm in a glass needle and injects it directly into the egg.
ICSI was first used at UCSF in 1994, and our first successful birth achieved with ICSI assistance was in February of 1995. UCSF was the first San Francisco Bay Area program to achieve a pregnancy and birth with this procedure.
Who should consider ICSI?
ICSI is considered absolutely necessary is in the case of male factor infertility with an abnormal semen analysis. In the Bay Area, however, about 75 percent of all IVF cases are now ICSI. Patients are electing to undergo ICSI for reasons other than male factor infertility, including:
Many patients choose to undergo the ICSI procedure in order to maximize their success even when the procedure is not clearly indicated.
If you have been told that there are abnormalities with any sperm test results, you should give serious consideration to ICSI. If the male partner has had a vasectomy reversal, we also recommend ICSI regardless of the sperm quality because of the presence of sperm antibodies that may affect fertilization.
The decision to proceed with ICSI is particularly difficult if there is no prior evidence of male factor infertility. Some couples choose ICSI because they want to do everything possible to maximize fertilization. However, it is important to understand that for many couples with normal sperm parameters, maximal fertilization can be achieved with standard insemination during IVF without the use of ICSI.
Who should consider split ICSI?
For couples interested in knowing about their own fertilization capability, we offer split ICSI. This option involves performing ICSI on a majority of all mature eggs and incubating the remainder with sperm. In effect, split ICSI can provide a safety net against failed fertilization with standard insemination.
The fee charged for split ICSI is the same as ICSI. One requirement for split ICSI is a minimum number of mature eggs. We must be able to identify at least eight mature eggs on the day of your egg retrieval in order to proceed with split ICSI. If this requirement is not met, we will inject all of your mature eggs.
How successful is ICSI?
Through the ICSI procedure, many couples with difficult male factor infertility problems have achieved pregnancy at UCSF. Fertilization rates of 70 to 80 percent of all eggs injected – equivalent to fertilization with normal sperm – are currently being achieved, and pregnancy rates are comparable to those seen with IVF in couples with no male factor infertility.
The most important indicator of ICSI success appears to be the fertilization rate achieved with the ICSI procedure. The fertilization rate in the UCSF IVF laboratory is exceptional – currently 80 to 85 percent. That is to say, on average, eight out of every 10 eggs will fertilize normally.
What are the risks associated with ICSI?
There are several risks. First, during the ICSI procedure, a small number of eggs – usually less than 5 percent – can be damaged as a result of the needle insertion. Second, the overall risk of having a baby with a chromosomal abnormality in the X or Y chromosomes is 0.8 percent, or eight per 1000, which is four times the average seen with spontaneous conception. At present, we do not know the reason for this increased risk.
It is important to understand that the following problems can be associated with sex chromosome abnormalities:
The risk of having a chromosomal abnormality like Down's syndrome is not increased with ICSI but increases with maternal age.
Several studies have addressed the issue of developmental delays in children born of ICSI. However, there is no conclusive evidence that this is the case.
Will all of our eggs be injected?
If you decide to proceed with ICSI, we will make every effort to inject as many eggs as possible. It is important for you to understand that only eggs that are mature can be injected with sperm. Our IVF laboratory can easily tell if an egg is mature or immature. Although the immature eggs are incubated with sperm, the likelihood of fertilization is very low. On average, we are able to inject 75 percent to 80 percent of the eggs that are recovered.
The information on this page is a general overview of 2 types of assisted reproductive treatment (ART):
More detailed information is available on the Victorian Assisted Reproductive Treatment Authority (VARTA)External Link website.
IVF and ICSI are forms of assisted reproductive treatment (ART) in which eggs are fertilised with sperm outside the body.
IVF is used for female infertility and unexplained infertility, and ICSI is used when there is a male cause of infertility.
Sometimes ICSI is offered when there is no male cause of infertility, but research shows that this does not increase the chance of having a baby.
The steps involved in IVF and ICSI treatment are:
Clinics report success ratesExternal Link in different ways. When comparing clinics’ success rates for IVF and ICSI make sure you compare like with like, or ‘apples with apples’. And, most importantly, you need to consider your own personal circumstances and medical history when you estimate your chance of having a baby with IVF or ICSI.
The woman’s age is the most important factor determining the chance of having a baby with IVF. See what the chance of having a baby is after one, 2, and 3 IVF or ICSI cycles for women of different agesExternal Link .
In the hands of experts, IVF and ICSI are safe procedures and medical complications are rare. But, as with all medical procedures, there are some possible health effects to consider for women and men undergoing treatment and for children born as a result of treatment.
Risks associated with IVF and ICSI include:
IVF and ICSI are also psychologically demanding and emotional health effectsExternal Link are common. In Australia, counselling services are available in all fertility clinics. Women who have IVF treatment, and their partners, are encouraged to use these if they experience emotional difficulties.
In Australia, Medicare (and private health insurance ) covers some of the costs associated with IVFExternal Link and ICSI but there are also substantial out-of-pocket costs.
The difference between the Medicare benefit and the amount charged by the clinic is the out-of-pocket cost. These costs vary, depending on the treatment, the clinic and whether a patient has reached the Medicare Safety Net thresholdExternal Link .
Sometimes people have embryos in storage that they don’t intend to use. Most commonly this is because they have completed their family, but for some people, health reasons prevent them from using their stored embryos. At the end of the storage time limit, which in Victoria is 5 years, people need to decide what to do with unused embryos.
There are 4 options available:
Here we consider how IVF and ICSI differ, and when ICSI would be recommended as opposed to conventional IVF.
What is IVF?
IVF places your eggs with prepared sperm in culture media within a laboratory dish. The sperm will naturally penetrate the egg leading to fertilisation overnight. The resulting embryos will develop in an incubator for three to five days. Your embryos are monitored by an embryologist and the best will be chosen for transfer to your womb.
What is ICSI?
With Intra-Cytoplasmic Sperm Injection (ICSI) a single sperm is selected by an embryologist, taken up in a fine glass needle, and injected directly into each egg. Your fertilised egg (embryo) is then transferred into your womb in the same way as an IVF cycle.
How are IVF and ICSI similar?
ICSI is similar to IVF as eggs and sperm are collected from each partner or donor. On the day of egg collection, an embryologist inseminates the eggs and the following day selects out those that are fertilised. They are kept and monitored in an incubator for up to five days and the best embryos are transferred into your womb to implant.
What is the difference between IVF and ICSI?
ICSI differs from IVF as each egg is individually injected with a single sperm, bypassing the stage where the sperm has to naturally penetrate the egg.
When is ICSI used?
ICSI is used if the sperm is unlikely to fertilise an egg naturally. This may be when:
• Sperm count is very low• Sperm can’t move properly• Sperm has a high rate of abnormality• Sperm is retrieved directly from the epididymis (PESA) or the testicles (TESA), from the urine, or by electro-ejaculation• There are high levels of antibodies in the semen• Previous IVF treatment has resulted in failed fertilisation• Sperm has been frozen
What ICSI offers
ICSI treatment offers men with very few sperm (oligospermia), no sperm (azoospermia) in their semen but have had successful surgical retrieval of sperm, or high numbers of abnormal sperm that are unable to fertilise an egg, the chance of having their own genetic child with their partner.
For patients using frozen sperm, or who have had a previous failed cycle due to low fertilisation, it also offers the chance of achieving a pregnancy.
IVF and ICSI at Complete Fertility
Our expert fertility consultants at Complete Fertility Centre will advise you on the best fertility treatment for your needs, based on fertility investigations as required.
We have world-class success results for IVF and ICSI and highly competitive fixed price packages.
