What is IVF?

IVF (In Vitro Fertilization) is an assisted reproduction option where eggs are extracted from a woman’s ovaries, sperm is retrieved from the male, and then the egg and sperm are combined in the laboratory to result in fertilization and an embryo. The resulting embryo will be grown and then transferred through the cervix into the woman’s uterus.

What is ICSI?

ICSI (Intracytoplasmic Sperm Injection) is a method that facilitates the fertilization of eggs and sperm. This laboratory-based technology selects the best sperm, which is then injected directly into each egg cell to improve the fertilization rate. The resulting fertilized egg, known as an embryo, is cultivated in an incubator until it reaches the blastocyst stage. At this point, the embryo is transferred back to the uterine cavity to achieve a pregnancy.

Why choose ICSI?

Depending on the cause of each couple, there are many technologies to treat infertility. ICSI is one of the treatments with the highest pregnancy rate today. This technology has numerous advantages which are:

Compare ICSI assisted fertilization with IVF which is the first technique in in vitro fertilization, where IVF involves placing eggs and sperms into a petri dish, so that eggs and sperms fertilize on their own. In this method eggs and sperms may not be able to fertilize for various reasons. For example, eggs with thickened shells which are more common in advanced maternal age will make it difficult to fertilize because sperms cannot penetrate the eggs. But with ICSI technique, sperms are directly injected into the eggs. It can increase the chance of conception compared to IVF.

During ICSI, when embryos reach day 5 of development, scientists will do the biopsy by taking a small amount of embryo cells for chromosome test which does not affect the embryo development. The test will identify whether or not the embryo has chromosome abnormalities, such as Down syndrome. Furthermore, for families with a history of genetic diseases, such as thalassemia, ALS, color blindness can be screened. Chromosome examination ensures that once the embryo is transferred back into the uterus, a successful pregnancy is achieved. The resulting child will have less chance of chromosomal abnormalities.

Embryos from IVF can be stored for more than 10 years. Couples who achieve successful pregnancies from their first attempt can freeze and store any remaining embryos for future use. If another child is desired, then they can come for embryo transferring again. In this approach the chance of pregnancy is comparable to natural pregnancy at the same age. Or in case of couples who are not ready to have children, but worried that as they age it may be difficult to have children. ICSI makes it possible to store frozen embryos. When the couple is ready, the embryo can be transferred back into the uterus to achieve pregnancy.

ICSI has a 60% chance of pregnancy, surpassing the rate of natural conception. However, success rate can vary depending on maternal age. For instance, women under 35 years old have a natural conception chance of 30-40% while those over 35 have a chance of about 20-30%. And for those over 40 years old, the chance is approximately 10-20%. Those couples who are under 35 having sexual intercourse 2-3 times a week and trying for 1 year or couples who are over 35 having sex regularly for 6 months but are unable to conceive. It is advisable to consult a fertility specialist promptly.

Who is suitable for ICSI?

  1. Couples who are unsuccessful in conceiving naturally
  2. Women age 35 years old and above
  3. Women with fallopian tube abnormalities, such as narrowing or blockages
  4. Women with ovulation dysfunction
  5. Women with endometriosis
  6. Women with severe pelvic adhesion
  7. Men with low sperm count or poor sperm quality
  8. Men who are sterile or have undergone vasectomy, but are still able to produce semen
  9. Unexplained infertility
  10. Couples with a genetic disorder
  11. Couples who have had failed IVF attempts
  12. Couples seeking genetic disease screening by NGS and Karyomapping

ICSI process

  1. Consult with a medical professional for a physical examination, planning and preparation before commencing the treatment
  2. Ovarian stimulation in female
  3. Matured eggs are retrieved from the ovaries of the female
  4. Collect semen from the male
  5. Fertilization in laboratory by ICSI
  6. Embryos are cultured for 5-6 days until blastocyst stage is reached
  7. A small number of embryo cells may be biopsied for chromosomal or genetic abnormalities screening.
  8. Select a normal embryo for transfer into the uterus of the female
  9. Pregnancy Test

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What is the success rate of ICSI?

ICSI is an option for couples facing difficulty in conceiving. It improves the chance of success up to 60%. In the process of IVF, in order to increase the chance of implantation as well as reduce the risk of miscarriage, genetic screening can be performed (Check chromosomes or genes) on the embryos before transfer. It is also suitable for people with genetic diseases and those who concerns about hereditary conditions.
The success rate of ICSI depends on factors such as

  • The age of the female partner. As age advances, the quality of eggs tends to decrease.
  • Is the number of retrieved eggs from stimulation sufficient?
  • How is the quality of retrieved eggs from stimulation?
  • Sperm morphology and vitality.
  • Is the thickness of female endometrium adequate?

Complications of In Vitro Fertilization (IVF)

  • Side effects and adverse reactions to medications. Particularly from stimulant medications, or Ovarian Hyperstimulation Syndrome (OHSS).
  • Complications from egg retrieval procedure, such as slight vaginal bleeding or pain.
  • Ectopic pregnancy / miscarriage / twin pregnancy

How to prepare yourself before starting ICSI treatment

  • Follow a healthy diet that includes meat, whole grains, seafood, eggs, selenium which is found in Brazil nuts, mushrooms, iron-rich foods, and vitamin supplements like Folic, Zinc, CoQ10, Vitamin C and E
  • Refrain from alcohol consumption, smoking and excessive intake of caffeinated beverages.
  • Exercise regularly. And sleep before 10 p.m.
  • Evaluate whether the medications you are currently taking may adversely affect fertility or not
  • Avoid environments that are exposed to hazardous chemicals, such as pesticides, chemical fertilizers, lead, mercury.
  • Avoid activities that affect sperm quality, such as hot bath, sauna (lasting more than 30 minutes), heating pad, electric blanket, and tight clothing such as tight pants. Cycling can cause friction and concussion which increases the temperature of the testicles.