Intracytoplasmic Sperm Injection (ICSI) in Iran

What is In Vitro Fertilization (IVF)

In vitro fertilization (IVF) stands as a groundbreaking assisted reproductive technology designed to support couples facing infertility challenges. The process involves the meticulous collection of sperm from the father and fertile eggs from the mother, facilitating fertilization in a specialized embryology laboratory. The resulting embryo is then carefully transferred back into the mother’s uterus, allowing it to grow and develop until a baby is delivered. IVF emerges as the forefront in assisted reproductive technology, providing a beacon of hope for millions of infertile couples. This includes those dealing with issues like unhealthy sperm in men or women aged 35 and above with diminished egg counts, offering them the opportunity to realize their dream of a complete family.
the details of ICSI procedure

The details of ICSI

Intracytoplasmic Sperm Injection (ICSI) is a groundbreaking fertility treatment that has revolutionized the field of assisted reproductive technologies. It offers hope to individuals and couples facing male factor infertility or other fertility challenges. Let’s delve into the details of ICSI and understand how it works.
What is the difference between IVF and ICSI?

What is the difference between IVF and ICSI?

Fertilization Process: IVF relies on natural fertilization in a dish, while ICSI involves the direct injection of a single sperm into an egg. Sperm Selection: IVF uses a concentration of sperm for fertilization, while ICSI requires the selection of a single, healthy sperm. Use Cases: IVF is suitable for a range of infertility issues, while ICSI is specifically designed for cases of severe male-factor infertility or instances where previous IVF attempts have failed due to fertilization issues.

Intracytoplasmic Sperm Injection (ICSI)

ICSI serves as a specific technique within assisted reproductive technologies (ART) and is an integral part of in vitro fertilization (IVF). This method entails the selection of a singular, potent sperm with optimal motility, directly injecting it into a fertile ovum using a micro-needle for assisted fertilization. The subsequent cultivation of the embryo in a sterile embryology laboratory leads to its development into a day-5 blastocyst. This blastocyst is then transferred to the uterus, enabling continuous growth within the womb. Recognized as a secure and highly effective medical technology, ICSI addresses male-factor infertility concerns, such as unhealthy sperm or low sperm count, as well as challenges faced by women with low egg counts, thick eggshells, or an unhealthy uterus.

Exploring the ICSI Procedure

Pre ICSI Procedures
• Physical Examination: Before embarking on the ICSI procedure, a comprehensive physical examination is conducted by the obstetrician to evaluate the health readiness of the mother-to-be. This includes a strategically timed blood test and ultrasound examination during the 2nd or 3rd day of the menstrual period. The results inform the dosage of hormones required for ovarian stimulation, considering factors such as physical health, age, and the outcomes of the physical exam.
• Ovarian Stimulation: Upon confirmation of readiness, the obstetrician initiates the ovulation induction process through daily hormone injections, stimulating the growth and maturation of multiple eggs for simultaneous fertilization. Typically, eggs reach full maturity 8-14 days after the initial hormone injection.
• Monitoring Oocyte Growth: Periodic transvaginal ultrasounds are performed to track the number of eggs and assess follicle growth. Subsequent hormone injections stimulate oocyte maturation in preparation for egg retrieval within 34–36 hours.
• Egg Retrieval: When eggs are deemed ripe for retrieval, the obstetrician conducts a minimally invasive procedure under light sedation. This involves inserting a thin needle through the vaginal wall, guided by ultrasound, to collect the eggs. The eggs are then transferred to an egg culture medium until ready for fertilization, with the entire process lasting approximately 20–30 minutes.
• Sperm Collection: On the same day as the female’s egg retrieval, the obstetrician schedules a sperm collection appointment for the male partner. If inconvenient, the male partner can provide sperm earlier, keeping it frozen until the female is ready for egg retrieval. To ensure optimal sperm quality, the obstetrician advises refraining from sexual activities, masturbation, and ejaculation for about 2-3 days before sperm collection.

On the day of sperm collection, the father-to-be with normal reproductive function is instructed to masturbate into a sterile container in a private room. Within 60 minutes, the ejaculate is sent to an embryology laboratory for semen analysis. The embryologist selects the healthiest and strongest sperm, nourishing them in a nutrient solution to enhance mobility before injecting them into the egg for fertilization. In cases of male-factor infertility with complete absence of sperm, alternative methods like Percutaneous Epididymal Sperm Aspiration/Testicular Sperm Extraction (PESA/TESE) are employed to retrieve sperm before facilitating fertilization.

Procedure during ICSI

• ICSI Fertilization: The embryologist carefully selects healthy mature eggs, placing them on a lab dish. An egg is firmly held in place with a pipette, and the healthiest sperm is drawn into the tip of a thin glass needle before being injected into the egg for fertilization.
• Embryo Culture: Following successful fertilization, the embryologist cultures the embryo for 3-5 days. The fertility doctor and embryologist monitor the embryo’s development through various cell division stages until it reaches the blastocyst stage on day five after fertilization. Embryos are cultured in a specialized nutrient solution under controlled laboratory conditions, mirroring the environment within the mother’s womb. This ensures optimal temperature, humidity, gases, and pH levels to facilitate embryo growth before proceeding with embryo grading and transfer procedures.

How is ICSI and IVF done?

In general, like all other medical and beauty cases on the IranMedTour team, you first start your work with online medical consultation and after that…

Post ICSI Procedures

• Embryo Transfer: The transfer of embryos into the uterus occurs through either a fresh embryo transfer (ET) or a frozen embryo transfer (FET).
• Fresh Embryo Transfer (ET): This involves placing the embryo into the uterus during the same induction-ovulation cycle. Typically, the fertility doctor performs the embryo transfer 5–6 days after egg retrieval, once the embryo reaches the blastocyst stage. The embryo must exhibit good growth and development, and the mother-to-be’s condition must be pregnancy-ready. The fertility doctor uses a trans-abdominal ultrasound to guide the placement of the embryo into the uterine cavity for implantation and a safe pregnancy.
• Frozen Embryo Transfer (FET): This method delays the embryo transfer to a subsequent ovulation cycle, avoiding potential side effects like ovarian hyperstimulation syndrome (OHSS), endometrial hyperplasia, or edema. The embryo is frozen and thawed when the mother’s physical condition is ready for the transfer in a subsequent ovulation cycle.

• Pregnancy Test: Approximately ten days after the embryo transfer procedure, the fertility doctor schedules a pregnancy test. The obstetrician checks for pregnancy through a blood test, measuring beta-HCG hormone levels and assessing other conditions. Upon confirmation of pregnancy, the mother-to-be proceeds with standard antenatal care. The obstetrician schedules follow-up appointments to monitor the overall health of the mother-to-be, including regular ultrasounds to observe fetal development inside the womb at regular intervals.

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