Filter By Categories

ICSI Procedure: Steps?

Dr. Shwetha Y Baratikkae - Gynecologist

Dr. Shwetha Y Baratikkae, Contributor

Verified & Published on 24 Jan 2020

Dr. Shwetha Pramodh is also a very well qualified obstetrician and gynecologist, capable of handling high risk pregnancies and gynecological issues.

ICSI Procedure: Steps

ICSI Procedure: Steps

Intracytoplasmic Sperm Injection is a variation of IVF for male infertility. The process involves four main steps, , :

Ovarian Stimulation and egg retrieval: The process involves stimulation of the ovaries with medication to promote the growth of the follicles containing the eggs. The growth and development of these follicles are constantly monitored using ultrasound techniques or blood tests. Once the egg is deemed matured enough and ready to be released from the ovarian follicles, a dose of human chorionic gonadotrophin (HCG) is administered and the egg is then retrieved over a period of 35-38 hours post administration, using a fine hollow needle attached to the ultrasound probe, while the woman is sedated. This is followed by injection of progesterone to prepare the uterine lining for the egg to be transferred and for it to grow and mature. The eggs are cultured on nutrient media for growth and to prepare them for insemination.

Sperm selection: Sperms are collected on the same day that fertilization is supposed to take place. Sperms are selected after washing the semen and testing their DNA (selecting sperms on the basis of which ones have their DNA intact) using several media / solutions. More mature sperms are selected for the procedure.

Fertilization: The embryologist picks up a single spermatozoa using a fine glass micro needle, and injects it directly into the cytoplasm of the matured egg (after selection of the most suitable candidate, the most matured zygote from the growth medium). Normally, doctors wait for 16-18 hours for fertilization post insemination. The blastocyst (earliest structure of mammals formed post successful fertilization) is then allowed to develop in a specially designed culture medium for 2-5 days.

Embryo assessment: the embryos are normaly are evaluated and photographed by the embryologist, who along with the physician decides based on the rate of development and appearance of the embryos, which ones may be recommended to be transferred. Typically embryos in cleavage stage (day 3 after oocyte retrieval) or at the blastocyst stage (day 5) are selected for transfer. The chosen embryo is loaded into a transfer-catheter and passed through the cervix into the uterus, and gently released.

Vitrification normally follows embryo transfer where the remaining good quality embryos are frozen and kept for subsequent use if the current one is unsuccessful.