Intracytoplasmic Sperm Injection (ICSI) is an advanced form of In-Vitro Fertilization (IVF) that helps couples with severe male infertility achieve pregnancy. Unlike conventional IVF, where sperm fertilizes an egg naturally in a lab dish, ICSI involves injecting a single, high-quality sperm directly into an egg to enhance fertilization chances. This technique is widely used in cases of low sperm count, poor sperm motility, or unexplained infertility.
Step-by-Step Process of the ICSI Procedure
1. Ovarian Stimulation
The process begins with hormone injections to stimulate the ovaries, encouraging multiple eggs to mature. This step increases the chances of successful fertilization and embryo development.
- Medications like gonadotropins are administered for about 10–14 days.
- Regular ultrasound scans and blood tests monitor follicle growth.
- Once the eggs reach the desired size, a trigger shot (hCG injection) is given to induce ovulation.
2. Egg Retrieval (Oocyte Collection)
Around 36 hours after the trigger shot, eggs are retrieved using a minor surgical procedure called follicular aspiration.
- A thin needle is inserted into the ovaries through the vaginal wall under ultrasound guidance.
- The fluid containing eggs is collected and examined in the laboratory.
3. Sperm Collection and Preparation
On the day of egg retrieval, a semen sample is collected from the male partner or a sperm donor. If necessary, sperm can also be retrieved surgically through TESA, PESA, or Micro-TESE in cases of azoospermia (zero sperm count).
- The sample is processed to isolate healthy, motile sperm for injection.
- If sperm quality is extremely poor, specialized techniques like PICSI (Physiological ICSI) or MACS (Magnetic-Activated Cell Sorting) may be used to select the best sperm.
4. Sperm Injection (ICSI Procedure)
A highly skilled embryologist performs micromanipulation, where a single sperm is injected into the egg using a fine glass needle.
- Eggs are placed under a high-powered microscope.
- A single, morphologically normal sperm is carefully selected.
- The sperm is injected directly into the egg’s cytoplasm to bypass fertilization barriers.
5. Fertilization & Embryo Culture
After injection, eggs are incubated under controlled lab conditions for 16–18 hours to check for signs of fertilization.
- Successfully fertilized eggs develop into embryos over 3–5 days.
- Embryologists monitor their growth, selecting the best embryos for transfer.
6. Embryo Transfer
One or more high-quality embryos are transferred into the uterus through a painless catheter-based procedure.
- This step occurs on day 3 or day 5 (blastocyst stage).
- Any extra embryos can be frozen for future use via cryopreservation.
7. Pregnancy Test & Follow-Up
After 10–14 days, a blood test (beta-hCG test) is conducted to confirm pregnancy.
- If positive, further ultrasounds track fetal development.
- If negative, another frozen embryo transfer (FET) or new ICSI cycle may be planned.
Conclusion
The ICSI procedure is a revolutionary fertility treatment that maximizes fertilization success in cases of severe male infertility. With its advanced techniques, couples struggling to conceive have a higher chance of achieving their dream of parenthood.
