ICSI - Intracytoplasmic Sperm Injection

ICSI is the latest treatment in male infertility. It would embrace all male infertility starting from refractory oligo asthenospermia (semen count and motility are poor despite treatment) to obstructive azoospermia. Obstructive azoospermia means sperms are produced in the testes but they are not able to come out because of various factors. These include bilateral vasal aplasia, bilateral epididymal obstruction or failed micro surgical procedures like vasovasostomy and epididymal vasal anastomosis.

Now all the above mentioned conditions are treatable because of the latest scientific advancement. In ICSI the eggs are retrieved and each one is fertilized by a single spermatozoa by injecting the sperm into the egg under microscopic guidance. Fertilization occurs following this procedure, and embryos are formed. These embryos after checking developments for 2-3 days are then transferred into the uterus. The treatment may cost upto one lakh rupees. ICSI is useful to correct certain female factors also.

Indications

	Bilateral tubal block.
	Extensive adhesions around the uterus and tubes as insevere endometriosis and pelvic inflammatory disease.
	Loss of both tubes following tubal ectopic gestation.
	As an alternative to tubal recanalisation or recanalisation failure.
	Repeated failed intrauterine insemination.
	In refractory oligoasthenospermia.
	Unexplained infertility
	Immunological factors
	Fertilisation problems in the last 5 indications.

ICSI treatment is ideal because of better results.

Important events

	Hormonal injections for production of multiple ova (controlled ovarian hyper stimulation)
	Transvaginal Ultrasound guided ovum pick- up (taking out the eggs from the ovaries) done under short general anesthesia.
	In Vitro fertilisation.
	Embryo transfer (The deposition of fertilized embryos back into the uterine cavity) PGD (Preimplantation Genetic Diagnosis) is done wherever it is indicated.
	Luteal phase support
	Pregnancy Test – Blood Beta HCG level estimation is done on 15th Post Transfer day.
	If result is positive, medications are continued and ultrasound scan is done after two weeks to confirm fetal viability.

There is no surgery in IVF-ICSI Treatment

In IVF-ICSI treatment hospital stay is needed only for 2 days. But couple has to come to hospital for scanning and or hormone level estimation for about 8-9 times.