IVF - ICSI

Many couples are now able to achieve pregnancy and have the baby that they so earnestly desire. How ? I'm sure you have ever heard about IVF ( invitro fertilization), invitro is a word from Latin which means "within the glass", so what's exactly the connection between IVF and pregnancy? That's a good question !

In-vitro fertilization (IVF) is a procedure, an assisted pregnancy, by collecting your eggs from your ovaries then those eggs are fertilized by your husband’s choosen sperms outside of your body, in a glass of labolatory (remember what invitro means) to produce one or more embryos. One to three embryos are then placed in your uterus for implantation and development into one or more babies.

Intra Cytoplasmic Sperm Injection (ICSI) is one of modifications of IVF. Here, the sperm is injected into the egg. It is usually performs when sperms are unable to enter eggs by their own power. IVF is recommended when you are unable to conceive in the normal way or when other treatments have not succeeded in helping you produce a baby. It has been performed by Palermo et al. in 1993, it was the first successful application of ICSI. Since that time, ICSI has been performed extensively in multiple centers to treat patients with male factor infertility. ICSI is currently the most successful treatment for male infertility, with fertilisation rates of 60%-70% depending on quality of the sperm used.



Indications for ICSI is there a problem with the male partner’s sperm whether problem of moving, amount, and ability of fertilize. Including if he doens't has sperm in his semen but has live sperm in his testes or epididymis, we should performs ICSI.

And How Is The Procedure ?
Usually, your physician will give you (female partner) fertility drugs to stimulate your ovaries with the aim to grow several mature follicles. Eggs are usually collected by a vaginal ultra sound scan, into a specially prepared culture medium. Once the eggs are collected, they are examined under the microscope to analyze their quality.

About the same time as the eggs are being gathered, your partner (male partner) needs to provide a fresh sample of sperm. If donated sperm is being used, the sample is taken from the freezer. The sperm needs to be washed and the chosen sperms (Morphologically normal active sperm) extracted ready to fertilize the eggs.

After selecting the eggs, a chosen sperm is rendered immobile, then sucked into the tip of the very fine glass needle and injected directly into the egg. The egg is held in place by gentle suction on the opposite side using a holding pipette. A very delicate, sharp and hollow needle is used to immobilize and pick up a single sperm. This needle is then carefully inserted through the shell of egg and in to the cytoplasm of the egg. The sperm is injected in to the cytoplasm and the needle carefully removed. The eggs are checked the next morning for evidence of normal fertilization This is a very delicate procedure and involves using a micro manipulator. This process is repeated for each egg.

The eggs are cultured over night and examined on next morning for fertilization. The embryos are allowed to grow and divide for further 24-48 hours. Not all fertilized eggs will divide and some embryos may arrest(stop growing) at an early stage of development. When they grow upto 6-8 cells (3 days) embryos are transferred into the womb to give a greater chance to be conceived from the chosen.

What's the Risk of IVF-ICSI ?
Pregnancies which is resulting from ovarian stimulation are at risk for spontaneous abortion (10-16%), ectopic pregnancy (3-5.5%), and multiple gestational.