A new hope for fertility: All about the ICSI treatment method (Intracytoplasmic Sperm Injection)

Making the dream of having a child come true can sometimes be a big challenge, right? This is a very sensitive topic, especially for couples struggling with the problem of childlessness. So today we are going to talk about a special treatment method in modern medicine that can help with such problems. That is ICSI, or Intracytoplasmic Sperm Injection . Although this name is a bit complicated, let's understand it very simply.

What is ICSI? What is the difference between IVF and ICSI?

ICSI is a special treatment method used for infertility. Strictly speaking, it is a part of In Vitro Fertilization (IVF) .

Imagine, in a typical IVF procedure, a woman's egg is taken in a laboratory and surrounded by thousands of man's sperm. Then, one of those sperms pierces the egg by itself and waits for fertilization to occur. It's like winning a race. But sometimes, not even one sperm can get inside the egg. Then fertilization doesn't happen.

The fertilized egg is called an embryo . This embryo is then implanted in the mother's uterus. If the embryo attaches to the uterine wall, pregnancy occurs. This technique is called Assisted Reproductive Technology (ART) .

Who is most likely to need ICSI treatment?

ICSI is especially useful for men with male infertility problems. Your doctor may suggest this treatment if the man has any of the following conditions:

In addition, ICSI may be necessary for other reasons:

• If previous regular IVF treatments have been successful and no embryo has formed.
• If the woman providing the eggs is over 35 years old.
• If previously frozen (cryopreserved) eggs or sperm are used for treatment.

How does the ICSI process happen?

This is a process that takes place in several steps. Let's look at those steps in order.

1. Collecting eggs and sperm

Egg Retrieval:

• Ovulation induction: First, the woman who is providing the eggs is given daily hormone injections for about 8 to 14 days. This stimulates the ovaries and causes them to mature several eggs at once.
• Egg retrieval: Next, a light anesthetic is administered, a very fine needle is inserted through the vagina, and the mature eggs are carefully removed from the ovaries under the guidance of a transvaginal ultrasound scan. This is not painful.

Sperm Collection:

• Sperm is usually collected on the same day as the eggs are collected.
• The male donor should refrain from sexual intercourse or masturbation for two to three days.
• Then, you need to collect semen by masturbation into a special container provided at the clinic. This sample must be delivered to the laboratory within an hour.
• Some men (e.g., in cases of azoospermia ) may require other special methods to obtain sperm (e.g., microscopic testicular sperm extraction ).

2. ICSI process in the laboratory

Now is the most important moment. In the laboratory, specialists do the following:

1. A mature egg is gently picked up with a very fine glass pipette .

2. Then, looking through a microscope, the best sperm is selected and captured with a very fine needle.

3. Now the needle is carefully inserted into the egg and the sperm is injected into the cytoplasm of the egg.

4. Then the priest takes out the needle.

3. Embryo development and implantation in the uterus (Embryo Transfer)

After ICSI, the fertilized egg, or embryo , is left to develop in the laboratory for about 5 to 6 days. During this time, it divides into cells and reaches a stage called a blastocyst .

Then, the best-quality embryo or embryos are placed into the mother's uterus through a special tube (catheter) . This does not require anesthesia. If this embryo attaches to the uterine wall (implantation), pregnancy is successful. The doctor advises to test for pregnancy about two weeks after the treatment.

What are the benefits and risks of ICSI treatment?

However, as with any medical treatment, there are risks involved, and it's important to be aware of them.

• Some eggs may be damaged when pierced with a needle.
• Even if sperm is inserted, sometimes the egg may not be fertilized.
• The resulting embryo may stop growing after it is implanted in the laboratory or in the uterus.

Possible risks to the child:

Some studies have shown that children born with ICSI have a slightly increased risk of certain congenital conditions. However, medical experts believe that this risk is not due to the treatment itself, but rather to the underlying cause of infertility. These risks include conditions such as Angelman syndrome, autism, and Beckwith-Wiedemann syndrome . However, this risk is very small. Talk to your doctor about this.

Chances of having twins:

To increase the chances of pregnancy, sometimes more than one embryo (e.g. two) is implanted in the uterus. In this case, the chances of having twins or triplets are higher.

When should you see a doctor?

After treatment, if you experience the following symptoms, call your doctor immediately :

• Signs of infection , such as high fever and foul-smelling vaginal discharge.
• Symptoms of an ectopic pregnancy (severe abdominal pain on one side, fainting).
• Symptoms of miscarriage (heavy bleeding, abdominal pain).
• Symptoms of premature birth .

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