In Vitro Fertilisation with intracytoplasmic sperm injection (IVF-ICSI)

In Vitro Fertilisation with intracytoplasmic sperm injection (IVF-ICSI)

This technique involves the insemination of sperm into each egg by micro-injection.
With ICSI, only one sperm is needed per egg. Without ICSI, you need between 50,000 and 100,000.
AT EUGIN CLINIC, THIS TECHNIQUE IS USED IN ALMOST ALL IVF TREATMENTS.
2 to 5 days 2 to 5 days

Egg harvesting
Hormones (a daily dose) are used to stimulate the ovaries to produce eggs. This procedure is monitored.

Egg retrieval
Aspiration under sedation. You can carry on with your everyday life after just two hours.

Preparation of sperm
Motile sperm is selected.

ICSI
This technique involves the insemination of sperm into each egg by micro-injection.

The fertilized eggs become embryos ready to be implanted in the uterus.

Embryo transfer
1 to 3 are selected and are placed in a thin catheter and then inserted deep inside the uterus by the gynaecologist.

Cryopreservation
The embryos that are not transferred are frozen in liquid nitrogen and are then carefully labelled and stored in the embryo bank.

These can be used in subsequent cycles if a pregnancy is not achieved on the first attempt. This simplifies things and reduces costs.

In Vitro Fertilisation with intracytoplasmic sperm injection (IVF-ICSI)
A

Egg harvesting. Hormones (a daily dose are used to stimulate the ovaries to produce eggs. This procedure is monitored

B

Egg retrieval. Aspiration under sedation. You can lead a normal life after two hours
C

Preparation of sperm. Mobile sperms are selected
D

E

F

Embryo transfer. 1 to 3 are selected and are placed in a thin catheter and then inserted deep inside the uterus by the gynaecologist
G

Crioperservation. The embryos that are not transferred are frozen in liquid nitrogen and are then carefully labelled and stored in the embryo bank. These can be used in subsequent cycles if a pregnancy is not achieved at he first attempt. This simplifies things and reduces costs

In recent years, in vitro fertilization with intracytoplasmic sperm injection, also known as ICSI for its acronym in English, is routinely used.

This technique involves the insemination of an egg by a sperm microinjection. The steps before and after insemination are exactly as in a classical IVF without ICSI, the only change is the insemination technique. To perform ICSI only one sperm is needed per egg, while in a classic IVF without ICSI between 50,000 and 100,000 are needed. Once fertilised, the egg becomes a pre-embryo and is transferred to the uterus to continue development.

ICSI was developed in 1992 to treat cases of male infertility or abnormalities in the sperm: azoospermia (no sperm), oligozoospermia (low concentration of sperm), asthenozoospermia (low motility) or teratozoospermia (poor sperm morphology) and since then there have been major advances made in the treatment of infertility of male origin. Today it is routinely used. Here at Eugin Clinic, we practice ICSI in 99% of cases, unless otherwise indicated.

ICSI procedure

Monitoring and stimulating the ovaries

1. Monitoring and stimulating the ovaries

The ovaries are stimulated by administering hormones (FSH, Follicle Stimulating Hormone and in some cases, Luteinising Hormone, LH) and the cycle is monitored using scans until the follicles reach the correct number and size (only one follicle is needed for this technique). At this point, another hormone is administered that imitates LH, the hormone that naturally triggers ovulation (LH or Luteinizing Hormone), and this results in an egg being released.

Egg harvesting and in vitro fertilisation

2. Egg harvesting and In Vitro Fertilisation

Harvesting the eggs is done by inserting a needle into an ovarian follicle and aspirating it. The procedure is done while the woman is under sedation. Once they have been removed, the eggs are stored in a culture dish while the semen is prepared to separate out the motile sperm. Then the eggs are denuded, which means that the cells on the surface are removed, and a single sperm is injected into each one.

Transfer

3. Transfer

The day after harvesting and the ICSI procedure we will know how many eggs have been fertilised. Over the next 2 or 3 days, these fertilised eggs become pre-embryos ready to be transferred to the uterus.

On transfer day, the pre-embryos showing the best signs of developing are selected. The law permits us to transfer up to 3 pre-embryos, but the average number is 2.

The pre-embryos are placed in a thin catheter and the gynaecologist inserts the eggs deep inside the uterus. No anaesthetic is required for this procedure. Of the transferred pre-embryos, normally only one will implant, but bear in mind that sometimes more than one may implant, resulting in multiple pregnancy.

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4. Cryopreservation

The pre-embryos that have not been transferred are frozen in liquid nitrogen (this type of cryopreservation is known as Vitrification) and they are then carefully labelled and stored in the embryo bank. These pre-embryos can be used in subsequent cycles if a pregnancy is not achieved on the first attempt. Evidently, the treatment for preparing the uterus for the transfer of frozen embryos is much simpler as there is no need to stimulate the follicles and harvest the eggs.

Last Updated: January, 2016
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