ICSI (Intracytoplasmic sperm injection) Treatment In Gurgaon

Make your parenthood possible through ICSI (Intracytoplasmic Sperm Injection)Treatment in Gurgaon. At Thakral hospital the ICSI treatment is performed by the most senior and experienced fertility expert Dr. Neeru Thakral - Gynecolo

Get Complete Knowledge and Guide About ICSI Treatment

ICSI (Intracytoplasmic Sperm Injection) is an advanced assisted reproductive technology that has revolutionized fertility treatment, particularly for couples facing male factor infertility. This procedure involves the direct injection of a single sperm into an egg, bypassing many natural barriers to fertilization.

Intracytoplasmic Sperm Injection is a specialized laboratory technique performed as part of an IVF cycle. Unlike conventional IVF where sperm and eggs are mixed together in a culture dish, ICSI involves the precise injection of a single sperm directly into the cytoplasm of a mature egg using microsurgical equipment.

The procedure was first successfully performed in 1992 and has since become a standard treatment for severe male factor infertility. ICSI has enabled millions of couples worldwide to achieve pregnancy when conventional fertility treatments have failed.

ICSI is recommended in specific clinical scenarios where conventional IVF may not be successful. Understanding these indications helps patients and healthcare providers determine the most appropriate treatment approach.

• Oligozoospermia (Low Sperm Count): When sperm concentration falls below 15 million per milliliter, natural fertilization becomes challenging. ICSI can achieve fertilization even with very few viable sperm.
• Asthenozoospermia (Poor Sperm Motility): When less than 40% of sperm show normal movement, they may struggle to reach and penetrate eggs naturally.
• Teratozoospermia (Abnormal Sperm Morphology): When fewer than 4% of sperm have normal shape, fertilization rates decrease significantly with conventional methods.
• Oligoasthenoteratozoospermia (OAT): This condition combines all three factors above, making ICSI often the only viable treatment option.
• Obstructive AzoospermiaMen with blockages in their reproductive tract may produce sperm that cannot reach the ejaculate. Surgical sperm retrieval combined with ICSI allows these men to father biological children.
• Previous Fertilization FailureWhen conventional IVF cycles result in poor or no fertilization despite good quality eggs and sperm parameters, ICSI may be recommended for subsequent cycles.
• Immunological InfertilityHigh levels of anti-sperm antibodies can prevent natural fertilization by interfering with sperm-egg interaction. ICSI bypasses this immune response.
• Genetic Conditions
Certain genetic disorders affecting sperm production or function may require ICSI for successful fertilization.

Understanding the ICSI process helps patients prepare mentally and physically for treatment. The procedure involves several carefully coordinated stages.

Female Partner Assessment:

• Ovarian reserve testing (AMH, FSH, antral follicle count)
• Hormonal profile evaluation
• Uterine cavity assessment via ultrasound or hysteroscopy
• General health screening and infectious disease testing

Male Partner Assessment:

• Comprehensive semen analysis including sperm DNA fragmentation
• Hormonal evaluation (testosterone, FSH, LH)
• Genetic screening when indicated
• Physical examination for varicoceles or other abnormalities

The female partner undergoes controlled ovarian hyperstimulation using fertility medications to produce multiple mature eggs. Common protocols include:

• Long Protocol: GnRH agonist followed by gonadotropins
• Short Protocol: GnRH antagonist with gonadotropins
• Mild Stimulation: Lower doses of medications for women at risk of OHSS

Monitoring involves regular ultrasounds and hormone level checks to track follicle development and prevent complications.

Natural Collection:

Standard semen sample collection after 2-7 days of abstinence.

Surgical Sperm Retrieval:

When no sperm are present in the ejaculate, surgical procedures may be performed:

• TESA (Testicular Sperm Aspiration): Needle aspiration of sperm from testicles
• TESE (Testicular Sperm Extraction): Surgical removal of testicular tissue
• MESA (Microsurgical Epididymal Sperm Aspiration): Extraction from epididymis
• PESA (Percutaneous Epididymal Sperm Aspiration): Needle aspiration from epididymis

Mature eggs are collected through transvaginal ultrasound-guided aspiration under conscious sedation. The procedure typically takes 20-30 minutes and involves:

• Insertion of a needle through the vaginal wall
• Aspiration of follicular fluid containing eggs
• Immediate transfer of eggs to the embryology laboratory

• Sperm Preparation: Viable sperm are isolated from the sample using density gradient centrifugation and swim-up techniques.
• Egg Assessment: Mature eggs (metaphase II) are identified and prepared for injection.
• Microinjection Process:
  • A single motile sperm is immobilized and aspirated into a fine injection pipette
  • The egg is held in place using a holding pipette
  • The injection pipette penetrates the egg membrane
  • The sperm is deposited into the egg cytoplasm
  • The pipette is carefully withdrawn

Approximately 16-18 hours after ICSI, eggs are examined for signs of fertilization (presence of two pronuclei). Fertilized embryos are cultured for 3-6 days, during which their development is monitored.

• Day 1: Fertilization check
• Day 3: 6-8 cell embryo stage
• Day 5-6: Blastocyst stage (preferred for transfer)

Selected embryos are transferred to the uterus using a thin catheter under ultrasound guidance. The number of embryos transferred depends on patient age, embryo quality, and medical history.

ICSI success rates vary based on multiple factors, and understanding these helps set realistic expectations.

ICSI typically achieves fertilization rates of 70-80% of mature eggs injected. However, not all fertilized eggs develop into viable embryos suitable for transfer.

Clinical pregnancy rates depend on:

• Female age: Women under 35 have higher success rates
• Egg quality: Directly related to ovarian reserve and age
• Embryo quality: Graded based on morphological criteria
• Endometrial receptivity: Uterine lining must be optimal for implantation

Female Factors:

• Age (most significant factor)
• Ovarian reserve
• Body mass index
• Smoking status
• Previous pregnancy history

Male Factors:

• Sperm DNA integrity
• Sperm concentration and motility
• Underlying genetic conditions
• Lifestyle factors

Treatment Factors:

• Laboratory quality and expertise
• Stimulation protocol used
• Embryo culture conditions
• Transfer technique

While ICSI is generally safe, patients should be aware of potential risks and complications.

• Egg Damage: The injection process may damage approximately 5-10% of eggs.
• Failed Fertilization: Despite injection, some eggs may not fertilize normally.
• Ovarian Hyperstimulation Syndrome (OHSS): Fertility medications can cause ovarian enlargement and fluid accumulation.

• Multiple Pregnancy: Higher rates when multiple embryos are transferred.
• Preterm Birth: Slightly increased risk compared to natural conception.
• Birth Defects: Some studies suggest marginally higher rates of certain congenital abnormalities.

Research continues to monitor long-term health outcomes for children conceived through ICSI. Current evidence suggests overall health outcomes are similar to naturally conceived children.

Modern fertility laboratories employ sophisticated techniques to improve ICSI outcomes.

Uses hyaluronic acid to select mature, DNA-intact sperm based on their ability to bind to hyaluronic acid receptors.

Employs high-magnification microscopy (6000x vs. 400x in standard ICSI) to select morphologically superior sperm.

Used when fertilization failure occurs despite successful sperm injection, helping activate the egg.

ICSI facilitates genetic testing of embryos by eliminating excess sperm that could interfere with DNA analysis.

Proper preparation can improve treatment outcomes and patient experience.

For Women:

• Maintain healthy weight (BMI 20-25)
• Take folic acid supplements (400-800 mcg daily)
• Limit caffeine intake
• Avoid smoking and excessive alcohol
• Manage stress through relaxation techniques

For Men:

• Consume antioxidant-rich diet
• Avoid excessive heat exposure
• Limit alcohol consumption
• Stop smoking
• Maintain healthy sleep patterns

• Pre-existing Conditions: Optimize management of diabetes, hypertension, thyroid disorders, and other medical conditions.
• Infections: Screen for and treat any reproductive tract infections.
• Medications: Review all medications with healthcare providers to identify any that might interfere with treatment.
• Nutritional Supplements: Consider CoQ10, vitamin D, and other fertility-supporting supplements as recommended.

ICSI treatment involves multiple components that contribute to the overall cost.

• Initial consultations and testing
• Fertility medications
• Monitoring appointments (ultrasounds, blood tests)
• Egg retrieval procedure
• Laboratory procedures (ICSI, embryo culture)
• Embryo transfer
• Pregnancy monitoring

• Surgical sperm retrieval procedures
• Embryo cryopreservation
• Genetic testing of embryos
• Multiple treatment cycles if needed

Coverage varies significantly by location and insurance provider. Patients should verify benefits and understand out-of-pocket expenses before beginning treatment.

ICSI treatment can be emotionally challenging, and addressing psychological well-being is crucial for patient care.

• Anxiety about treatment outcomes
• Stress from medication side effects
• Relationship strain from treatment demands
• Grief from previous treatment failures
• Hope and excitement about potential pregnancy

• Individual and couples counseling
• Support groups for fertility patients
• Online communities and forums
• Educational resources and materials
• Stress reduction programs

Appropriate post-treatment care optimizes outcomes and ensures patient safety.

• Rest for 24-48 hours after transfer
• Take prescribed medications (progesterone supplementation)
• Avoid strenuous activities
• Monitor for symptoms of OHSS
• Follow dietary and lifestyle recommendations

• Beta-hCG blood test 10-14 days after transfer
• Serial hormone monitoring if pregnant
• Ultrasound confirmation of pregnancy location
• Early prenatal care establishment

• Allow time for emotional processing
• Discuss results with medical team
• Consider modifications for future cycles
• Seek psychological support if needed

Research continues to advance ICSI technology and improve outcomes.

• Artificial Intelligence: AI-powered sperm and embryo selection systems
• Time-lapse Imaging: Continuous monitoring of embryo development
• Metabolic Profiling: Assessing embryo viability through metabolic markers
• Mitochondrial Assessment: Evaluating sperm energy production capacity

• Optimizing sperm selection techniques
• Improving egg activation methods
• Enhancing embryo culture systems
• Developing non-invasive embryo assessment tools

ICSI represents a significant advancement in fertility treatment, offering hope to couples facing challenging fertility issues. Understanding the procedure, its applications, and associated considerations helps patients make informed decisions about their fertility care. Success with ICSI depends on multiple factors, including patient characteristics, laboratory expertise, and proper preparation. While the treatment involves emotional and financial commitments, it has enabled countless couples to achieve their dreams of parenthood.