Intracytoplasmic sperm injection

‍ICSI (Intracytoplasmic Sperm Injection)is an advanced laboratory technique in which a single sperm is injected directly into the cytoplasm of an egg to achieve fertilization. This method is a revolution in the treatment of male infertility and is successfully used as part of IVF procedures.

The main difference from the standard in vitro procedure is in the laboratory stage associated with the fertilization of eggs.

In classic in vitro fertilization, the egg is inseminated in a special petri dish with thousands of sperm of the partner. During the ICSI procedure, an experienced embryologist releases the eggs from the pregnant female eggs with the help of the enzyme xialiponidase. Cold moving and lowering of the subcutaneous cppematozoid with the so-called injection (insertion) pipette, the egg cup, the egg cup such as a holding pipette and an injection of a metazoid into the cytoplasm of an egg.

The manipulation is carried out using a special technique /micromanipulators/ under microscopic control, repeated 200-400 times, with a pipette repeated 20 times (with a pipette) and 60 times (with a pipette) and 60 times (with a pipette). an injectable pipette) is a sample of the diameter of a person's mouth. The egg that has been typed into the egg cell will enter the insemination tank and 16-18 hours before it is ready for fertilization.

When is ICSI applied?

ICSI is a recommended method in:

• severe disorders in the spermogram — low concentration, poor mobility, poor morphology;
• presence of antibodies to sperm - may be present in the male's ejaculate or in the cervical secretion of the female partner;
• cases of in vitro fertilisation in which fertilisation has not occurred in a previous attempt with a standard in vitro procedure;
• use of frozen semen of lower quality;
• in the complete absence of sperm in the ejaculate (Azoospermia) and the use of sperm obtained by surgical methods (TESA, PESA, TESE);
• limited number of eggs available;
• Performed vasectomy, in which recovery cannot be successfully applied;
• Diagnosed with poor biological survival of cepematozoiditis;
• When using frozen/thawed eggs.

In the case of pregnant women, the number of persons employed in the activities of the type of crop, the method of which the population and the age of the two, in the case of the woman Pseudenal peppodytivna, ppoizxood.

How is the procedure going?

1. Egg preparation:After the puncture, the oocytes are processed in the laboratory by removing the surrounding cumulus cells with the help of the enzyme xyaliponidase to assess their maturity.
2. Sperm selection:Under a microscope, an experienced embryologist selects the best in morphology and motility spermatozoa.
3. Injection:Movable and displacing a podosed cepmatozoid with a so-called injection (insertion) pipette, egg cupping, etc. holding the pipette and injecting the selected cepmatozoid into the cytoplasm of a mature egg.
4. Fertilization assessment:About 16—18 hours later, it is checked whether fertilization has occurred and cell division has begun.
5. Cultivation of the Embryos:The fertilized eggs (zygotes) are grown to the appropriate stage — most often to a blastocyst (day 5-6).
6. Embryo transfer or freezing:usually one embryo returns to the woman's uterus, and the rest of high quality can be frozen.

What are the advantages of ICSI?

• Gives a chance of fertilization even with a very severe male factor, due to serious impairments of spermatogenesis, which would otherwise remain incurable.
• Allows the use of single sperm. Experience has shown that with the method ICSIthe presence of a minimum number of motile, normal in shape spermatozoa is required. Theoretically, only a few sperm are needed to perform the procedure;
• Improves the chances of fertilization in previous failures;
• An indispensable method in surgically extracted sperm.

Are there risks with the ICSI procedure?

ICSI is a safe procedure that has been applied for decades. There are no proven differences in the state of health of children born after ICSI compared to standard in vitro. However:

• Fertilization is not guaranteed — it depends on the quality of the eggs and sperm
• Embryos with lower development are possible in severe sperm abnormalities
• The genetic problem is not corrected - in case of severely damaged sperm it may be recommended genetic examination of embryos (PGT)

ICSI and other technologies

• ZyMot:It can be used before ICSI to select the best sperm.
• IMSI /PICSI:Upgraded selection options by morphology or maturity.
• Testicular biopsy:When there are no sperm in the ejaculate, but there is production in the testicles, they can be extracted and used for ICSI.

In our clinic, ICSI is performed daily by experienced embryologists using a highly specialized technique. We choose the best approach for each couple to maximize the chances of a successful pregnancy.

Frequently Asked Questions

1. Is ICSI better than standard IVF?
ICSI is not “better”, but more appropriate in specific cases, especially with male infertility factor. With normal sperm and eggs, classical IVF is also effective. The decision on which method to use is made by the team based on laboratory data.

2. Are all eggs fertilized in ICSI?
No. Despite the precise technique, successful fertilization depends on qualityof eggs and sperm. On average, about 70— 80% of mature eggsare successfully fertilized after ICSI.

3. Does ICSI affect the health of the baby?
Long-term studies have shown that children born after ICSI are healthyand develop normally. With a very severe male factor, further genetic examination of the embryos can be discussed.

4. Can ICSI be done in any couple?
Technically, yes. But the method is applied only when reasonably necessarybecause it is more invasive than standard IVF. For example, it is not routinely used in normal male factor.

5. How to choose the “right” sperm?
Embryologists select the most mobile and with the best morphology sperm under a microscope. If necessary, methods such as ZyMOT, PICSI or IMSIfor additional selection.

6. Can I do ICSI with frozen sperm?
Yes. ICSI is often used in recovered frozen semen, including from biopsies or donor samples.

7. Can ICSI be combined with other methods?
Yes, for example with preimplantation genetic diagnosis (PGT), Timelapse Systemsfor monitoring embryos, frizz-all strategyet al.