Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic Sperm Injection (ICSI) is an advanced laboratory technique where a single sperm is directly injected into an egg under a specialized microscope. This method is one of the assisted reproductive technologies (ART) and is typically used in cases of male infertility, where sperm are too weak or incapable of penetrating the egg for fertilization.
During ICSI, a small hole is made in the egg’s outer membrane under the microscope for about a minute, and then a sperm is directly injected into the egg. Sufficient and high-quality sperm are required from the husband. If a sufficient quantity of sperm is unavailable, the Micro-TESE procedure is performed to extract sperm directly from the testes.
Once the sperm is injected into the egg (intracytoplasmic injection), the embryos are stored in specialized incubators until they are ready for transfer. Sperm extraction from the testes involves inserting a fine needle into the epididymis using microscopic and endoscopic techniques to retrieve sperm. The epididymis acts as a reservoir for sperm.
This procedure is also used for individuals with:
- Congenital absence of the vas deferens.
- Previous infections causing testicular blockage.
- Ejaculatory dysfunction due to scarring or diabetes.
When ICSI is Recommended
ICSI is recommended for:
- Patients with low sperm count or complete absence of sperm.
- Women experiencing recurrent miscarriages.
ICSI Procedure
- Ovarian Stimulation:
The ovaries are stimulated to produce as many eggs as possible, monitored by ultrasound during consultations with a specialist. - Egg Retrieval:
The eggs are extracted from the ovaries for fertilization in the lab. - Egg Cleaning:
The cellular layer surrounding the egg is removed (cell cleaning) three hours after retrieval. - Incubation:
The eggs are incubated for two hours. - Sperm Preparation:
Depending on the case, sperm preparation is carried out:- In cases of no sperm production: If the male reproductive system fails to produce sperm or is unable to release sperm, a testicular biopsy is performed to extract sperm, if present.
- In cases of abnormal sperm morphology or movement: The best-shaped and most active sperm are selected.
- Microinjection Process:
- Using a specialized microscope, a single, isolated sperm is selected.
- The sperm is injected directly into the egg cytoplasm using a fine needle visible only under the microscope.
- Fertilization Check:
- After 24 hours, the eggs are examined to confirm successful fertilization.
