Many people are probably more familiar with the term ICSI (Intracytoplasmic Sperm Injection) than the term in vitro fertilization (In Vitro Fertilization: IVF). However, ICSI is only a step in the fertilization process between the egg and sperm during IVF. In this method, the doctor selects a high-quality sperm under a microscope and injects that sperm directly into the egg cell. ICSI increases the chance of obtaining embryos by up to 90% compared to the traditional IVF method, where eggs and sperm are mixed together naturally.
Advantages of ICSI
- Increases the chance of obtaining more embryos, especially for couples with sperm quality issues.
- Reduces contamination of the feeder cells when couples need to screen for genetic diseases using NGS or Next Generation Sequencing, a technology that can detect chromosomal abnormalities.
- Increases the chance of pregnancy due to more embryos being obtained in cases with poor sperm quality.
What problems does ICSI help with?
- Male problems with poor sperm quality or infertility.
- Female problems such as advanced age, where eggs may have difficulty fertilizing naturally, or issues with the fallopian tubes, such as previous surgery or blockage.
- Cases where couples have undergone traditional IVF but have low fertilization rates or no fertilization.
- Couples who need to screen for genetic diseases using NGS (Next Generation Sequencing).
Common risk factors for failure
- Egg quality, which may be affected by ovarian stimulation in older women, as egg quality tends to decline with age.
- Sperm quality, so if sperm quality is poor, consultation with a doctor is recommended before starting the ICSI process.
- Embryo quality, which usually depends on the quality of the eggs and sperm.
The ICSI procedure involves several steps similar to general IVF, which are:
- Screening to find causes of infertility and diseases that may affect the child in the future.
- Ovarian stimulation with hormone injections.
- Egg retrieval process.
- ICSI procedure.
- Embryo culture for 5-6 days and NGS or Next Generation Sequencing testing, a technology that can detect chromosomal abnormalities.
- Fresh embryo transfer into the uterine cavity.
- Embryo freezing.
- Preparation of the uterine cavity for frozen embryo transfer.
The average success rate of ICSI across all age groups of couples is approximately 40-50%. Younger age groups have higher success rates, while older age groups have lower success rates. The main reason for lower success may be due to genetic abnormalities in the embryos.
Therefore, genetic screening of embryos using NGS may increase the success rate by another 20-30%. In cases where the uterus is normal or healthy, the success rate can increase up to 80%.
Dr. Teerayut Jongwutiwes
Reproductive Specialist
Infertility Treatment Center, Phyathai 2 Hospital
