ICSI procedure comprises of certain specific steps which are executed under the guidance of the infertility specialist for achieving the desired results. Here are the medical steps which are performed in IVF ICSI procedure.
- IVF ICSI procedure commences with the diagnosis of male infertility issues along with presence of female or unexplained infertility issues. Here, the infertility expert creates a customized plan based on the requirement of the patient's case.
- Once the procedure is confirmed, the woman is given certain medications and hormonal injections to bring her body in the right state for conception. This helps in starting the procedure of IVF ICSI at a good note.
- After the woman's body starts responding well to the hormonal injections well, the infertility specialist performs the egg retrieval procedure. In this step, the quality eggs are removed from the woman under the expertise of the infertility expert.
- After the eggs are removed from the woman, the infertility specialist takes out certain amount of semen from the male partner. The semen consists of sperms which are required for the fertilization procedure. Prior to the removal of the sperms, a semen analysis test is performed to check the count, motility, and quality of the sperms. In some of the cases, donor eggs or sperms are also used depending on the complication of the respective case. This impacts the success rate of the procedure to a great extent, thus benefitting the couples opting for the procedure.
- When ICSI is utilized along with IVF procedure, fertilization of sperms and eggs takes place in an external environment i.e. in the embryology laboratory. Here, the embryologist uses an injection which is filled with quality sperm separated from semen collected from the male partner. He injects the sperm into the egg through the shell of the same. It reaches the cytoplasm of the egg. Here, the sperm fertilizes the egg. ICSI is mainly known for its simplified solution of fertilizing sperm and egg outside the body at the required temperature in the embryology lab.
- After the fertilization takes place in the lab, the embryo which is formed as a result of this step is transferred into the uterus of the woman. This step is known as the Embryo Transfer (ET). Embryo can also be frozen depending on the couple's family planning goals. Frozen or fresh embryos can be used in the infertility treatments of choice.
- Once the successful implantation takes place, pregnancy occurs in the woman. The pregnancy test is performed after two weeks of the embryo transfer procedure. Positive results in the pregnancy test announce the presence of pregnancy in the woman. (Source: Intracytoplasmic Sperm Injection: ICSI, American Pregnancy Association)
Medical Tourism and Demand of ICSI procedure:
The demand and growth of the IVF ICSI procedure is rising at a steady and proportional rate in different parts of the world. This has led to the increase in the practice of the infertility treatments in countries such as Ukraine, Georgia, Dubai, and India as well. Low costs of the treatments when compared to the costs of IVF ICSI procedure in the developed countries is one of the prime reasons for increase in the demand and utilization of IVF ICSI procedure in these countries. Ease of traveling from one country to another has also uplifted the demand of the medical tourism of infertility treatments. Other medical departments such as neonatal intensive care unit (NICU) also support the functioning of the infertility treatment departments at the medical centres. This has led to overall growth in the field of infertility medicine and treatments. (Source: Global Infertility Treatment Market 2018 - 2023, Cision PR Newswire)
ICSI PROS AND CONS:
Benefits of ICSI procedure:
Intracytoplasmic Sperm Injection (ICSI) is usually used in combination with In Vitro Fertilization (IVF) procedure. Here are some of the major benefits of ICSI procedure which need to be considered at the time of finding a solution for the infertility issues.
- Low Sperm Count: Most of the couples who face infertility issues because of male infertility are the ideal ones who are recommended to go for ICSI procedure. Low sperm count is one of the challenging issues which need to be dealt in the right way at the right point of time. IVF ICSI treatment will help the couples to have babies as this treatment combination fetches good success rates.
- Physical Blockage: In some of the cases, sperms cannot travel from their location at the time of intercourse. This makes it difficult for the sperms to travel and cause natural pregnancy. Here, ICSI needs to be utilized along with IVF procedure. This leads to the retrieval of the sperms from the male partner and this is used in the IVF ICSI procedure.
- Poor Sperm Count and Quality: The quality and count of the sperms also determine the requirement of ICSI along with IVF procedure. If the semen analysis shows that the sperm count and quality is lower than the required level, then ICSI procedure needs to be considered in such cases. Certain measures need to be practiced along with the use of the ICSI procedure.
- No success with IVF procedure: Every couple is not fortunate enough to receive success within one or more than one IVF cycles. In these cases, IVF procedure is combined with ICSI treatment to make sure that next level medical expertise is used for the chosen procedure. (Source: ICSI Benefits and Risks, Attain Fertility)
- Desire for pregnancy after vasectomy: Some couples decide to go for expanding their family even after the male partner chose for vasectomy procedure. In such cases, it is not possible to have a pregnancy with natural intercourse. Also, if a couple does not want to go for vasectomy reversal, then ICSI along with IVF procedure will help in successful conception of the baby.
- Usage of Frozen oocytes: Nowadays, there are couples and single individuals who opt for cryopreservation procedure. The outer covering or shell part of the vitrified oocytes usually get hardened during the time period of cryopreservation. This usually complicates the procedure of fertilization. Here, the infertility specialist advises the couple to go for the IVF ICSI procedure. In such cases, the embryologist performs the fertilization step in the embryology lab itself.
- Usage of Frozen Sperm in infertility treatment: If a couple chooses to go for infertility treatment with frozen sperms and they do not have the required features, then ICSI procedure occurs. Couples need to understand that frozen sperms increase the chances of success of IVF procedure, but there are certain other factors as well which determine the success of the procedure.
- PGD needs to be performed: Preimplantation Genetic Diagnosis (PGD) is an advanced medical technique which is implemented in the IVF procedure. Some couples are advised to go for IVF ICSI procedure to make sure they receive the proper treatment while choosing PGD test in their respective case. Some of the infertility experts have a concern that sperm cells which are free and did not fertilize the egg, 'hang around' embryo. This can impact the results of PGD test.
- Use of In Vitro Maturation (IVM): IVM is the medical technique in which the eggs are taken out from the ovaries in the woman. The final maturation of the eggs are performed in the IVF laboratory. As per some of the recent researches, IVM eggs do not mature as that in the conventional types of IVF procedure. In some cases, more amount of research is required where IVF needs to be combined with ICSI procedure. (Source: What You Should Know about ICSI-IVF, Verywell Family)
Like every other infertility treatment, ICSI procedure also comprises of certain disadvantages which need to be considered while opting for the procedure. This will help avoiding in facing any possible effects of the procedure. Women who opt for IVF ICSI procedure have high chances of attracting gestational diabetes, high blood pressure, and high possibility of cesarean section delivery of the baby. Birth defects such as sex chromosome abnormalities are one of the top risks of IVF ICSI procedure. (Source: ICSI Benefits and Risks, Attain Fertility)
IVF ICSI Success rates:
The success rates of IVF ICSI procedure varies from one case to the another. When ICSI procedure is combined with IVF treatment, the success rates increases to a great extent. The success rates of ICSI procedure when combined with IVF procedure ranges between 50 to 80 percent. The success rates of the IVF ICSI procedure depends on a range of factors which varies from one case to another. (Source: What You Should Know about ICSI-IVF, Verywell Family) The factors which determine the success of IVF ICSI procedure. Some of these factors include the following:
- Age of the couple: The age of the couple opting for the infertility treatment is one of the crucial factors which determine the ultimate success of IVF ICSI procedure. With the increase in the age, the success rates of the IVF ICSI procedure also varies accordingly. Therefore, most of the infertility experts specify that couples need to opt for the IVF ICSI procedure at an younger age to prevent any kind of complications.
- Past pregnancies: The occurrence and sustaining of the pregnancies in the past also lead to the ultimate success of the past pregnancy. One needs to understand that if there were certain complications in the past pregnancies, then the ultimate success rates will also vary accordingly. Infertility experts often perform an in-depth analysis of the past pregnancies in case of most of the couples who are struggling hard to conceive due to severe health problems. With this, the infertility expert also understands the time period for which the couple is facing infertility issues which is proving to be a hindrance towards their goal of parenthood.
- Types of infertility problems: The infertility problems which occur vary from one case to another. Here, the couples need to discuss their issues with the infertility specialist experienced with IVF ICSI procedure for the right diagnosis followed by treatment of the same. In most of the cases, either female or male infertility issues are responsible for lack of positive pregnancy in case of couples.
- Usage of donor eggs/sperms: These days, infertility problems can occur due to medical issues associated with eggs or sperms of the couples. When the donor eggs and sperms are used, the success of the IVF ICSI procedure also varies accordingly. Couples must take wise decision while choosing this infertility treatment combination for their infertility issues. The quality of the donor eggs and sperms forms a huge aspect while deciding the final success rate of the IVF ICSI procedure.
- Laboratory features: There are certain unique features in the IVF laboratory which are taken into consideration while determining the success of the IVF ICSI procedure. This includes presence and usage of the advanced medical technology in the embryology laboratory. The experience of the embryologist also signifies success rate of IVF ICSI procedure. Patients must research well before going to a fertility centre for their infertility treatment. In most of the medical laboratories, Heating, Ventilating, and Air Conditioning (HVAC) units are present to improve the air quality of the embryology laboratory in the respective infertility centre. These units help in moderating and keeping the air quality as per the requirements set by the medical authorities.
- Lifestyle factors: Lifestyle of the couple also determine the final success rate of a couple's IVF ICSI success rate. In some of the cases, the presence of excess weight in the body can also impact in the final success of the IVF ICSI procedure. Habits such as smoking also have negative effect on the treatment of the couple.
- Experience of IVF ICSI specialist: The experience of the IVF ICSI specialist is one of the crucial factors which determines the final success of the IVF ICSI procedure. Therefore, it is recommended to make sure that while choosing IVF ICSI specialist certain parameters are taken into consideration to receive the desired results of the same. The best IVF ICSI specialist prioritize the patient's treatment needs and accordingly go ahead with the treatment of the patient. Patients need to make sure that they ask the concerned doctor about their expertise in the field of infertility treatments along with their medical education. Most of the patients hesitate to ask doctors about their expertise but then in case of doubts patients must inquire about the respective doctor from the hospital itself. (Source: What factors determine IVF Success Rates?, SCRC)
- Choice of Fertility Clinic: When the fertility clinic is to be finalized, there are several deciding factors which come into the scenario. These factors play a important role in finding out the best fertility clinic for the infertility treatment of the patients. One of the important points which you need to check is the success rate of the shortlisted fertility centres which offer IVF ICSI procedures for infertile couples. Just make sure that you check the recent stats only while finding out the figures of success rates. Infertility treatments pose to be a challenge for the couples. This makes it important for the couples to inquire about the presence and utilization of the advanced medical technology at the respective fertility centre. With the use of the modern equipments and technology, the fertility clinic will ensure that the success rates of the infertility treatments performed at the centre are quite impressive and useful for the patients as well. Patients also need to talk about the cost of the recommended infertility treatments to make sure that there is sufficient amount of transparency in the chosen procedure. (Source: What is a Fertility Clinic? How to Choose the Right One, WebMD)
Cost of ICSI procedure:
The cost of IVF ICSI procedure varies from one country to another and the final cost depends on a range of factors. The cost of IVF ICSI procedure in Georgia ranges from Georgian Lari 11,400 to Georgian Lari 21,900. The final cost changes depending on the success rates of IVF ICSI procedure in the chosen country. The cost of IVF ICSI in Ukraine varies from UAH 99,000 to UAH 190,400. The cost of IVF ICSI procedure in India ranges from Rs. 2,00,000 to Rs. 3,50,000. The expertise of the IVF specialist and the facilities available at the chosen fertility clinic also determine the final cost of the IVF ICSI procedure for the respective couple. (Source: Fair Treatment Cost, Elawoman)
Health Concerns related to ICSI procedure:
Some of the latest studies mention that there are certain concerns which revolve around the IVF ICSI procedure. Birth defects can also be seen in some of the babies which are born with the assistance of the IVF ICSI procedure. Imprinting defects are one of the commonly occurring birth defects which involve different functioning of the genes based on the chromosome passed into the baby. (Source: Intracytoplasmic Sperm Injection: ICSI, American Pregnancy Association)