Introduction to ICSI

In the current days, the issues with infertility and the recorded case have been higher than ever before. With the growing stress of life and multi-folded lives of people, the course of procreation is often shelved and avoided until the actual desire of pregnancy, which is not ideal for the reproductive organs of both men and women. In such cases, people often resort to the best and most effective method of pregnancy.

Dr. Uday (INDIRA IVF HOSPITAL) explained “In Vitro Fertilization (IVF) is a procedure of fertilization in which an egg is taken from the female’s ovary is combined with a sperm from a male body in a controlled, external environment. The process is carried out by stimulating the woman’s ovulatory movement. The eggs and sperm mixed outside the body, where they are fertilized. The embryos resulting from the fertilisation are implanted in a woman’s uterus, where they are expected to convert into a fetus”.

Intracytoplasmic Sperm Injection (ICSI) is an specially assisted fertilization procedure. It serves the same purpose as the IVF; the difference is in the process of fertilization.

Usually, in IVF, the eggs and sperm combined in a dish and the sperm penetrates the egg in its natural process. However, it can become a little bit of a risk, as underperforming eggs and sperm sometimes don’t go through that action properly. Many factors play a role in the successful implantation of the embryos.

In ICSI, the laboratory picks the single unit of the concerned sperm with the help of a glass needle and is injected straight into the respective egg. Experts of Embryology monitor the whole procedure and a different set of specially made equipment is used in the process.

As opposed to IVF, ICSI no longer requires the egg to be penetrated naturally, as the machines do it. And so, the volume of sperms used in this process is reduced. This also ensures that even the poor performing eggs can be utilised for successful implantation. However, this does not ensure that the fertilisation is successful, as the ordinary course of fertilisation still need to befall once the sperm is carefully placed in the egg.

Difference Between IVF and ICSI:

Dr. Yogita Parihar (INDIRA IVF HOSPITAL) defines, “For a patient, there is no difference between IVF and ICSI, except for the financial factors. But, as a procedure, the difference comes into play as the eggs are forcefully penetrated by a group of professionals. Hence, the entire process of ICSI depends upon the reproductive functionality of the woman”. When fertilization is successful, the resultant embryos are placed in the uterus. The rest of the process is identical to that of IVF. ICSI is undertaken when there’s an abnormality in the sperm performance of the male member. It is an assistive infertility treatment, making it an elective procedure.

Who can choose ICSI?

Dr. Manju parmar (INDIRA IVF HOSPITAL) explained, “The procedure for getting an ICSI is precisely similar to that of IVF, as the steps involved are identical for a patient”.

ICSI is used when the sperm donor has fertility problems. The male infertility results in decreased sperm performance. The cases of male infertility may include deteriorated sperm movement and disfigured shape. In rare cases, the ejaculations do not carry sperm, even though the testicles are entirely forming sperms.

ICSI is assistance to an established process, and hence, it is appropriate for those who have abnormal sperm performance, which includes:

Decreased Sperm Movement

Low Sperm Count

Surgical retrieval of the sperm (MESA/PESA)

(TESE/TESA) Urine Ejaculation

Previous failure of IVF implantation

High levels of antibodies in the semen

Prerequisites for the ICSI

Serial ovary stimulation, which aids in the development of eggs.

Egg retrieval

Embryo implantation into the walls of the uterus

The success rate of ICSI

The icsi success rate in India depends upon the patients and their health spectrum. But research has proven that 25% of the patients are able to conceive after a single attempt at ICSI. A study conducted in the US concluded that IVF with ICSI has a similar success rate as that to a traditional IVF done of couples with healthy sperm quality. Once the Embryologist does the artificial penetration, other actions came into play as well. And so, the success also depends upon the age of the eggs. ICSI can be considered as a measure to ensure mingling of the eggs and sperm, and not a guarantee of pregnancy.

There are specific sets of risk when you opt for the ICSI fertilization procedure, which is the same as the traditional IVF cycle.

ICSI treatment does not lay any underlying danger on the children born, but there’s a 1.5 to 3% of possible congenital disabilities. Although the chances are slim, the registered defects are also rare. Some studies have stated some particular risks of Assisted Reproductive Technology (ART), which are – sex chromosome abnormalities, degraded quality of sperm, urinary system defects, Angelman Syndrome and hypospadias. But the chances of these effects coming into play are very rare.

IVF is an invasive procedure, and so, it has some underlying risks such as ovarian cancer, and other reproductive failures.

Here are the risks exposed to the IVF host:

The drugs injected for fertility can expose women to many irregularities, such as chromosomal and fetal functioning.

The medications given aren’t FDA regulated, and so, they can be dangerous if taken in a high dosage.

The skill and expertise of the doctors involved are crucial to the procedure.

The long term effects on the women who have sought IVF treatment is still unclear.

The effects of IVF-ICSI on women:

Ovarian Hyperstimulation Syndrome

OHSS is a condition where the ovaries are abnormally enlarged and are filled with fluid. During ovulation, the liquid is released back in the body, which causes complications.

Cancer

Although the increased cases of breast and ovarian cancer have shown inconclusive results, studies have shown that the infiltration caused during the procedure is unfavorable to women’s reproductive organs. The health of women also comes in question here. Women with weight issues have a higher risk of being exposed to cancer after the procedure.

Psychological effects

The drugs involved in the fertility treatment may result in a series of side effects, especially on a subconscious level. The procedure can result in anxiety, depression, sleep deprivation and severe mood swings.

ICSI Treatment Cost in India

The treatment cost of ICSI treatment come to ₹ 250000. The procedure required experienced and embryologist and a team of experts, hence, is categorized as a selective infertility treatment. The mentioned amount is exclusive of fertility medications, secondary procedures and genetic tests. The entire ICSI cost in India can come out to be between ₹ 200000 to Rs 400000. Each cycle of ICSI treatment (in which a single sperm is injected straight into an egg) can add up to the cost, so the ICSI treatment cost in India may range between ₹ 1,50,000-2,50,000.

The patients have to prepare themselves that it may take more than a single cycle for a successful IVF transplant, as IVF has a 27% chance of success.

You can reuse the frozen embryos, which can significantly reduce the cost of the cycle. The cost of a frozen embryo transfer can come up to ₹ 1,20,000.

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