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Intracytoplasmic Sperm Injection (ICSI) has given hope to many couples who earlier had very faint chances of bearing a child. ICSI is usually advised if there are less than 1 million total number of sperm in the ejaculate. Click to see big picture

The procedure involves a sperm being injected through the outer covering of the egg into the cytoplasm. As a precaution to prevent the abnormal amounts of genetic material being introduced, only one sperm is injected via a glass micro-injection pipette. Rest of the treatment remains the same as IVF-ET procedure.

ICSI is a relatively new treatment but with a high success rate & is being used worldwide to treat severe male infertility.

Procedure


The procedure involves ovarian stimulation & the handling of oocytes. The success of a ICSI program depends on.

  1. Ovulation induction procedure & oocyte retrieval essentially similar to that of regular IVF program.
  2. Oocytes are scored for their maturation. The metaphase II (M) oocytes are selected on the basis of absence of germinal vesicle and presence of 1st polar body and are incubated for about 4-5 hours at 37º C in CO2 incubator.
  3. Prior to micromanipulation, the oocytes are denuded, that is, the cumulus and corona cells are removed. The removal of these cells is necessary for observation of the oocytes and effective use of holding and/or injecting pipette. Cumulus cells are removed by exposure to HEPES-buffered human tubal fluid (HTF-HEPES) containing 80 IU/ml of hyaluronidase. For final removal of corona cells the oocytes are repeatedly aspirated in and out of a hand drawn pasteur pipette. Each oocyte is again examined under microscope to assess the maturation stage. Oocytes which show absence of germinal vesicle and presence of 1st polar body are most suitable for ICSI.

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