ICSI has brought about remarkable progress and a major revolution in the field of reproductive medicine, especially in solving infertility problems in men as a result of their weak sperm, low number and motility, or delayed or lost ejaculation. Many may wonder about the steps of this process, and what is its success rate?
ICSI
The ICSI process relies on injecting sperm into the cytoplasm of the egg until fertilization occurs, and this procedure occurs in medical laboratories.
When the egg is fertilized and the embryo is formed in the laboratory under good conditions and control, the doctor takes it and implants it in the uterus until it attaches to the lining and pregnancy occurs.
This procedure is usually used in cases of male infertility.
Advantages of microscopic injection
ICSI helps solve the problem of reproduction in many men and women, such as:
- Cases of female infertility, such as endometriosis, blockage or rupture of the fallopian tubes, and ovulation disorders.
- Cases of infertility in men, such as: varicocele, non-ejaculation, insufficient number of sperm, or poor quality.
- Women over the age of 35 due to decreased ovulation or weak eggs.
You can also view Early pregnancy symptoms
Disadvantages of ICSI
Some defects or side effects may occur during the procedure, such as:
- Some or all of the eggs are damaged when the needle penetrates them.
- Failure to fertilize the egg after sperm injection.
- The egg stops dividing and the embryo forms or grows, whether in the laboratory or after implantation in the uterus.
Some medical studies also indicated that approximately 1-2% of children born through ICSI may suffer from congenital problems, which is a very small percentage.
Congenital problems in babies born using ICSI include:
- Autism spectrum or autistic disorder.
- Angelman syndrome, which is a congenital problem that affects the fetus's nervous system.
- Beckwith-Wiedemann syndrome, a genetic disorder that affects a child's development, is also known as a developmental disorder.
- Gender differentiation disorders.
- Hypospadias, which is a congenital condition that affects the development of the fetus’s urethra or the foreskin of its penis.
- The presence of intellectual disabilities.
You may be interested in: A method for calculating ovulation days
Microinjection steps
We will learn below about the steps of ICSI in detail, which begin by preparing both spouses by stimulating the ovaries with some hormones to produce viable and fertilized eggs. Then the following steps of the process begin:
- After the egg matures, it is retrieved under anesthesia using an internal ultrasound, and this process takes about half an hour.
- This is followed by the step of withdrawing semen from the husband by submitting a semen sample, and the sperm is separated after selecting the best one in terms of quality.
- The doctor injects the egg with one sperm after choosing the best one, which is injected directly into the egg to begin the fertilization process.
- After the injection, the doctor monitors the fertilization process for 16 hours, and upon checking for signs of fertilization, the fertilized egg is implanted in the mother’s uterus using a thin tube that is inserted into the uterus.
- Two weeks after the ICSI procedure, the doctor begins to confirm the occurrence of pregnancy by performing an ultrasound scan.
Symptoms of successful ICSI
Before the expiry of the period during which the doctor informs both spouses to confirm the occurrence of pregnancy, there are some symptoms that may appear on the woman, and they are known as symptoms of the success of ICSI, and they include the following:
- The menstrual period is delayed beyond its scheduled date.
- Frequent urination is a distinctive sign of pregnancy.
- Notice light blood spots a week or 10 days after the operation.
- Increased vaginal discharge after the procedure, which indicates the success of the injection.
- Feeling pain and cramps in the abdomen and pelvis, similar to menstrual pain, and this is what I noticed in my experience with the ICSI process in detail.
- What ultimately confirms the success of the operation is a blood test and the appearance of the gestational sac 15 days after ICSI.
Reasons for failure of the ICSI process
The doctor usually informs the couple about the possibility of failure of the operation to set all expectations, and introduces them to the most prominent reasons for the failure of the ICSI operation, which include:
- Genetic factors affect the stability of the fertilized egg inside the uterus.
- The lack of quality of the egg chosen for the operation or the presence of abnormalities in the sperm that were injected with the egg.
- Suffering from some diseases such as thyroid dysfunction and autoimmune diseases that affect the outcome of the operation.
- The uterus rejects the fertilized egg due to a medical problem such as uterine adhesions, uterine fibroids, or endometriosis.
My experience with ICSI in detail
In the following lines, Mrs. Areej Khaled tells us in detail her experience with ICSI. She says: “I have been married for 5 years and did not get pregnant during the first two years, so my husband and I decided to go to the obstetrician and gynecologist to find out the reason.”
“The doctor began examining me via ultrasound to evaluate my condition, then he asked the two of us for some examinations and tests so that he could diagnose the condition well. Then he made an appointment for me on the tenth day of my menstrual cycle to examine the ovulation process and the size and number of eggs and follow them, and I went to him day after day.”
“After the results came out, we discovered that my husband had a problem with his sperm count, and this delayed pregnancy.”
“The doctor gave me hormonal injections to stimulate the release of eggs, their growth and maturation, then he asked me to go to him on the tenth day of my menstrual cycle to monitor the eggs, their number and size via ultrasound.”
“When the eggs reached the appropriate size, he asked me to prepare for the extraction the next day.”
Read also about: Artificial insemination
How does the egg extraction process occur in ICSI?
Mrs. Areej continues: “The next day, I underwent local anesthesia to retrieve the mature eggs and transfer them to the egg culture in the laboratory. This procedure took approximately 30 minutes.”
“At the same time, the doctor brought my husband into another room to collect the sperm, to examine them in the laboratory, and choose the healthiest ones, to put them in a nutrient solution to nourish them before injecting them into the eggs.”
“The doctor advised my husband not to have sexual intercourse for 2-3 days before collecting the animals to extract as much as possible.”
How does in vitro fertilization occur?
When the doctor sends the sperm and eggs to the lab, the specialist will select the mature eggs, place them in a dish, then select the good sperm and inject each one into an egg with a thin needle.
The specialist places these eggs in a nutritional solution that resembles the conditions of the mother’s uterus in terms of temperature, acidity, and humidity for a period of 3-5 days to facilitate the process of division and embryo formation.
Signs of ICSI failure
As for signs of ICSI failure, there are many signs that may appear during the first weeks after the operation, including:
- Menstruation is the most prominent sign of ICSI failure.
- Severe cramps and constant cramps, which suggest failure of ICSI.
- Feeling severe pain in the pelvis and lower abdomen, in addition to bleeding.
- Negative results of a pregnancy test and the absence of a gestational sac upon ultrasound.
- The absence of all early pregnancy symptoms, such as frequent urination, fatigue, and some breast changes.
Do not worry. Even if the ICSI fails, you can try again until the procedure is successful and pregnancy occurs. It just requires patience and repeated attempts with a doctor with long experience and competence, such as the doctors at the Fertility Center inside Al-Mousa Specialist Hospital.
What happens after in vitro fertilization?
At this stage, Ms. Areej continues her speech by saying: “The doctor made an appointment for me 7 days after the egg extraction process to implant them in the uterus, and then he asked me not to move for about two hours.”
“I then went home, and the doctor asked me to perform a pregnancy test after about 10 days. Thanks to God, the procedure was successful, and now I have Mazen.”
How long does the ICSI process take?
The ICSI process takes approximately 4 to 6 weeks, from the physical examination and examinations to the stage of implantation of the embryos in the uterus.
احجز استشارتك في مركز الخصوبة At Al Mousa Specialist Hospital
Is the ICSI procedure painful?
Women do not feel pain during the ICSI process, because the doctor puts them under local anesthesia while retrieving or implanting the eggs.
How many days of bed rest after ICSI?
There is no specific period for rest. Some doctors advise bed rest for two days, while others advise not moving or standing for two weeks. This difference is due to the woman’s general health and age.
What is the success rate of ICSI?
The success rate of ICSI is approximately 60-70%, which enhances the chances of pregnancy and childbirth.
What is the difference between ICSI and IVF?
Both are used to solve reproductive problems in women and men, but doctors may resort to... Artificial insemination (In vitro fertilization) if the problem is in women, while they prefer ICSI for infertility problems in men.
In conclusion, ICSI is one of the successful options for solving the problems of infertility and childlessness for many women and men. We only recommend that you adhere carefully to your doctor’s instructions to ensure the success of the procedure and achieve your dream of parenthood.
Frequently asked questions
What are the conditions for the success of ICSI?
One of the most important conditions for the success of the ICSI process is the quality of the sperm in terms of number and movement, and the quality of the eggs used for fertilization. The appropriate timing for performing the procedure must be chosen, in addition to ensuring the health of the uterus to receive the embryo.
How many sperm are needed for ICSI?
During the ICSI process, one egg requires a large number of sperm, which may reach 100,000 sperm cells, which are separated from the semen before the procedure to complete the injection steps.
Where do the embryos go if pregnancy does not occur?
If pregnancy does not occur, the remaining embryos remain in the laboratory for a period, then they are frozen at some stages to be implanted and injected in other subsequent attempts.
When is ICSI not useful?
ICSI is not useful in some cases, such as the absence of sperm or difficulty finding fertilized eggs, also in women over 45 years old, as the quality of the eggs decreases, which reduces the possibility of ICSI success.
Sources and references
Microinjection: Definition, Principle, Steps, Uses – microbenotes
Microinjection – sciencedirect
