Learn about intracytoplasmic sperm injection (ICSI)

The article is professionally consulted by MSc, BS. Nguyen Thi Nhu Trang - Reproductive Support Center - Vinmec Times City International General Hospital. The doctor has strengths and experience in performing specialized techniques in the IVF Lab such as ICSI, biopsies for preimplantation genetic diagnosis, thawing embryos, oocytes...

ICSI is a technique that allows the creation of embryos with only one egg and one sperm. This is one of the most commonly used assisted reproductive techniques today.

ICSI is an acronym for Intra-cytoplasmic Sperm Injection, which is a method of injecting sperm directly into an ovum to create an embryo. This technique is performed to increase the chances of fertilization. Specifically, a good quality sperm will be selected to be injected directly into the cytoplasm of the egg. After successful fertilization, the embryo will be cultured until the 3rd or 5th day and then transferred to the mother's uterus to implant and develop into a healthy fetus.

With normal IVF techniques, some cases of sperm cannot fertilize themselves because of fertilization abnormalities, resulting in no embryos to transfer into the uterus. But with ICSI technique, patients can avoid the above cases. The success rate of ICSI is less dependent on the origin and quality of the sperm. Except for severe sperm abnormalities, sperm taken from semen, epididymis or testicles have almost the same pregnancy rate. Thus, ICSI technique can help a man with poor sperm quality still be able to have children of his own.

Advantages of the technique of intracytoplasmic sperm injection in the treatment of infertility and infertility:
Help treat infertility in men: ICSI is an advanced assisted reproductive technology, helping to treat infertility in men. effective. This method helps men with low sperm count, poor sperm quality, etc. have a chance to become a father. Increased chances of successful fertilization: if a previous in vitro fertilization (IVF) procedure was unsuccessful due to an abnormality in fertilization, then using ICSI at the next treatment will help increase your chances of getting pregnant. The chances of conception are successful because the embryologists will closely monitor the fertilization process in the laboratory. Efficiency when using frozen eggs: recent studies suggest that ICSI will help insemination with high efficiency in the case of using frozen eggs. Therefore, frozen eggs from previous ovarian stimulation can be used in ICSI method, which saves a lot of cost and effort for the patient.

All types of abnormalities in sperm count and function in men such as: low sperm count, abnormal sperm count, poor sperm motility. Male infertility due to azoospermia: there are no sperm in the semen, sperm removal surgery is required. Men lack or damage the vas deferens (the part responsible for carrying semen from the testicles to the penis). Men who have had a vasectomy. Fertilization abnormality: the husband's sperm and the wife's eggs are normal but not fertilized or the fertilization rate is low, there is suspicion of an abnormality in the fertilization process between sperm and egg. Infertility of unknown cause. The wife has few eggs, poor quality. Fail many times with normal artificial insemination method.

The husband needs to provide a semen sample. The sample is then filtered and washed to select good motile sperm. In cases where it is difficult to obtain a sample or is not available on the day of aspiration, sperm can be frozen in advance to ensure sperm availability on the day of insemination. In cases where there is too little or no sperm in the sample, or when ejaculation is not possible, the doctor may perform a sperm aspiration from the epididymis, testicles or from the vas deferens.

The wife is injected with gonadotropin to stimulate the ovaries to produce more mature eggs for fertilization. The doctor will administer anesthesia, insert an ultrasound probe into the vagina to look at the ovaries, find the follicles. Then, the doctor will put a thin needle through the vaginal wall to aspirate eggs from the follicles, remove about 8-15 eggs, and put them in the IVF lab.

In the IVF Lab, embryologists inject each sperm directly into each egg. Three days later, each successfully fertilized egg develops into an embryo.

Depending on the age and other factors of the wife, the doctor will use a thin catheter inserted through the cervix to insert 1-2 embryos into the uterus.

If successful, an embryo will implant in the wall of the uterus and develop into a baby. Excess embryos can be frozen and used in future embryo transfer cycles. If multiple embryos are transferred, the chances of pregnancy are higher, but women are also at risk of having multiples. Approximately 20% of babies born through ICSI are twins, triplets, or more. Therefore, at present, Vinmec, we only transfer 1-2 embryos to minimize the risk of multiple pregnancies.

Usually, the wife will have the results checked about two weeks after the embryo is placed in the uterus.
Note:
It takes about 4 to 6 weeks to complete an ICSI cycle. The wife needs to wait for the ovaries to respond to the medication and for the eggs to mature. While on medication, the wife should make an appointment to see her doctor every two or three days for blood tests and ultrasounds. On the day of egg collection, both husband and wife need to spend several hours at the center to collect eggs and sperm. After about 3 to 5 days, the wife needs a follow-up examination to place the embryo in the uterus, which takes about 1-2 hours for the procedure. The wife will be tested for pregnancy about two weeks later.

Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technology that increases the success rate of infertility treatment. Currently, Vinmec International General Hospital is applying this technique to infertile couples. For more advice, you can go to Vinmec Fertility Center.
Vinmec Fertility Support Center is built and applies a treatment process that combines comprehensive examination, combining both obstetrics and gynecology and male medicine, giving the optimal plan for each specific case. The center gathers a team of leading experts in the field of obstetrics and gynecology domestically and internationally, trained in the US, Singapore, Australia, Japan,... With high expertise and long experience, a team of specialists Vinmec's experts can synchronously deploy the most advanced assisted reproductive techniques to patients, helping to realize the dream of parenthood of infertile couples.