What is ICSI? How does it help treat infertility? If you are experiencing infertility and have tried many methods without success, “ICSI” is another option that can increase your chances of pregnancy.
What is ICSI? Is it the same as IVF? How is it different from other methods? What are the advantages and disadvantages? Is it done on women or men? What are the chances of success? Who is it suitable for? What are the steps? Is it expensive? This article answers all these questions in detail.
What is ICSI?
ICSI (Intracytoplasmic Sperm Injection) is a fertility treatment process for infertile individuals by selecting healthy, strong sperm to fertilize an egg (ovum) and form an embryo. The embryo is then cultured in a laboratory and transferred into the uterus to develop until the due date. It is one of the in vitro fertilization methods to increase the chance of pregnancy.
Currently, ICSI is one of the Assisted Reproductive Technologies (ART) widely used in Thailand and globally recognized in medicine because it has a higher success rate than other methods. It helps couples facing infertility to achieve their dream of becoming parents.
What is the difference between ICSI and IVF?
ICSI and IVF are both fertility technologies used to treat infertility, but they differ in the fertilization process of eggs and sperm. The processes are as follows:
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ICSI
ICSI (Intracytoplasmic Sperm Injection) involves selecting the strongest sperm under a microscope and injecting it directly into the egg using a fine needle. After fertilization, the embryo is cultured in a special medium in the laboratory. Once the embryo reaches the appropriate stage, it is transferred into the uterus to continue the pregnancy.
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IVF
IVF (In-Vitro Fertilization), also known as test-tube baby, involves placing sperm and eggs together in a culture dish, allowing sperm to fertilize the egg naturally. The healthiest eggs and sperm are selected, and after fertilization, the embryo is transferred into the uterus for a normal pregnancy.
Who is suitable for ICSI?
ICSI is suitable for couples with fertility problems caused by:
- Couples unable to conceive after 1 year of regular, unprotected intercourse
- Women over 35 years old
- Women with a history of multiple unexplained miscarriages
- Men with abnormal sperm quality, very low sperm count, or weak sperm
- Couples who have tried other fertility treatments such as timing intercourse, IVF, GIFT, or IUI without success
- Couples with a family history of genetic diseases such as Thalassemia or previous births with genetic abnormalities
- Couples who have undergone sterilization but want to conceive again without surgery
- Women who have had tubal ligation, tubal cutting, or blocked fallopian tubes
- Men who have had vasectomy
How to prepare for ICSI
Preparation for ICSI requires cooperation from both partners to optimize the body’s readiness for pregnancy, with the following guidelines:
Preparation for women
Maintain proper health through diet, exercise, and rest.
- Focus on high-protein foods, vegetables, fruits, and freshly cooked meals
- Reduce high-fat foods, starches, sugars, fermented foods, pickled foods, processed foods, and alcohol
- Exercise regularly for 30-45 minutes at least 3-4 times a week
- Get enough sleep, go to bed before 10 PM, and sleep 7-8 hours per night to allow the body to repair and produce essential hormones normally
Additionally, women must strictly follow other medical advice for egg retrieval, such as:
- Taking vitamins or supplements as recommended by the doctor before egg retrieval and pregnancy to prepare the body and reduce risks to the baby
Preparation for men
Men’s preparation before ICSI aims to improve sperm quality suitable for fertilization. The preparation is similar to women’s as follows:
- Eat nutritious food focusing on protein, reduce fat, sweets, sugar, alcohol, and processed foods
- Get enough sleep
- Exercise regularly
- Avoid alcohol, smoking, including e-cigarettes
ICSI Procedure
The ICSI procedure is delicate, starting from before, during, and after the process, with the following details:
5 Important Steps Before ICSI
1. Physical examination
Before ICSI, couples must undergo a thorough physical examination to assess readiness, including:
- Blood tests to check blood health and infectious diseases such as HIV, syphilis (VDRL), and hepatitis B (HBsAg)
- Hormone level measurement affecting egg stimulation
- Ultrasound to check for abnormalities in ovaries and uterus, such as cysts or fibroids, their size, and location. Any issues must be treated before proceeding
- Men will have sperm quality analysis
2. Ovulation stimulation
If the examination results are normal and the body is ready, the process moves to ovulation stimulation by injecting hormones to grow eggs in the ovaries to an appropriate size. Various hormones are used in a proper sequence to prepare for egg retrieval.
3. Monitoring egg growth
After hormone injections, doctors monitor ovarian response by measuring hormone levels in the blood and using transvaginal ultrasound to count and measure follicles and endometrial thickness to ensure readiness.
4. Egg retrieval
When eggs mature, egg retrieval is performed under anesthesia by inserting a fine needle through the vagina into the ovaries to aspirate eggs for culture and fertilization. Ultrasound guides the needle placement.
5. Sperm collection
Sperm collection usually occurs on the same day as egg retrieval. Men are advised to abstain from ejaculation for 2-3 days before collection.
Healthy men with normal sexual function provide sperm by masturbation into a sterile container in a private room. The sperm is analyzed in the lab, and the healthiest, most motile sperm are selected, nourished, and prepared for injection into the egg.
If men have sexual dysfunction or have had a vasectomy, sperm may be retrieved directly from the testes for injection into the egg.
During ICSI
There are two key steps during ICSI: fertilization and embryo culture.
- Fertilization (ICSI fertilization): The medical team selects the healthiest eggs and sperm and injects sperm into the eggs to fertilize them.
- Embryo culture: After fertilization, embryos are cultured in a special medium that mimics the uterine environment for 3-5 days. Embryo development is monitored before grading and transfer to the uterus.
Embryo transfer
The medical team prepares the woman’s body for embryo transfer by administering medications and adjusting hormones to thicken the uterine lining to support embryo implantation. There are two types of embryo transfer: fresh and frozen.
- Fresh Embryo Transfer (ET): Transferring embryos created in the lab back into the uterus for implantation and pregnancy shortly after egg retrieval. This is a more natural process and can be done between day 2 and day 5 after fertilization in the same cycle as egg stimulation.
- Frozen Embryo Transfer (FET): Transferring previously frozen embryos into the uterus to achieve pregnancy. Current data shows higher pregnancy rates with frozen embryo transfer compared to fresh transfer.
After embryo transfer
After embryo transfer, progesterone hormone is given to support pregnancy and must be continued until the body produces sufficient progesterone naturally or under medical supervision.
When will the pregnancy result be known after ICSI?
About 7-14 days after embryo transfer, the doctor will schedule a pregnancy test by measuring Beta-HCG hormone levels in the blood.
How long does ICSI take?
The entire ICSI cycle takes approximately 4-6 weeks, starting from physical examination. The duration varies depending on egg retrieval, fertilization, embryo transfer, and other factors such as age, fertility status, and hormone levels.
Is ICSI painful?
Many couples worry about pain during ICSI, especially during egg stimulation, which involves subcutaneous hormone injections that can cause discomfort.
Egg retrieval through the vagina may cause mild pain or pelvic discomfort after the procedure (performed under anesthesia). These symptoms usually resolve within 1-2 days.
Why choose ICSI at the Infertility Center, Phyathai 3 Hospital?
The Excellence Fertility Center at Phyathai 3 Hospital provides infertility treatment using ICSI with internationally standardized reproductive technology, managed by a multidisciplinary team of experts and equipped with advanced tools to ensure effective and complete fertility care.
- Experienced obstetricians and gynecologists specializing in infertility treatment
- Specialist embryologists
- Dedicated fertility nursing team providing consultation and care
- Modern, internationally standardized medical equipment and innovative technology to increase pregnancy rates
- Embryo culture laboratories and surgical rooms to support embryo implantation
Currently, the Excellence Fertility Center at Phyathai 3 Hospital has helped many couples overcome infertility with the commitment to assist couples in achieving their dream of parenthood, providing accurate knowledge and proper infertility treatment.
