ICSI is a micromanipulation procedure whereby a single sperm is injected into the single egg with the help of small micro needle with the help of robotic machine called micromanipulator. Super ovulation, follicular monitoring, ovum pick up is done like that in IVF. This technique may provide men who have very small amounts of weak sperm (too small for routine IVF) a chance to fertilize individual eggs. When the egg is fertilized, the embryo is inserted into the uterus.
ICSI can be used when:
The number of sperm available is too few to expect fertilization; ie very low sperm count & motility, fertilisation has not occurred in previous IVF cycles despite a high number of sperm being present; the only sperm available are those which have been collected direct from the testis. eg in cases of congenital absence of vas or obstructive azoospermia.
ICSI / IVF splits
Sometimes, it is not possible to say in advance whether ICSI will be necessary to achieve fertilisation of eggs. An ICSI / IVF split involves treating half of the eggs with ICSI and half with IVF. In this way we can find out if ICSI is really necessary while still ensure that if IVF does not work at least some fertilized eggs are available for transfer. An ICSI/IVF split is normally only done if 12 or more eggs are collected. If fewer eggs than this were collected then ICSI would be carried out on all the eggs. Some The cost of this procedure is set at approximately halfway between the cost of full ICSI and IVF. Collecting sperm direct from the testis with a needle.
Other indication of ICSI may be - repeated IVF failures
- If not enough eggs could be retrieved from the woman as in woman with advance age.
- Unexplained infertility cases
- ICSI / IVF splits
PESA / TESE (Percutaneous epedydymal sperm aspiration or testicular sperm extraction).
Some men produce no sperm at all in their ejaculate. In these cases, sufficient sperm can sometimes be obtained by testicular sperm aspiration to treat their partner's eggs with ICSI. The procedure involves an insertion of a fine needle under local anesthetic so that the sperm may be sucked out into a syringe from a small tube at the back of the testis. Sometimes it is necessary to put the needle actually into the testis itself. Any sperm obtained may be used fresh, or frozen for later use in ICSI.