The process of IVF treatment using ICSI procedure (intracytoplasmic sperm injection) is quite extensive. ICSI involves preparation for oocyte puncture, collection of mature eggs under anesthesia, oocyte fertilization by intracytoplasmic sperm injection method, embryo culture and transfer of embryos to the uterus.
From the very beginning, this process should be agreed upon with the doctor, and it is worth choosing an individual program for every case. The doctor will prescribe the tests patients need to take to prepare for the intracytoplasmic sperm injection (ICSI) program and offer a stimulation protocol according to the menstrual cycle. In the simulation protocol, patients will have a schedule of medication and additional testing as needed.
According to the plan, the doctor invites patients to the clinic for an oocyte puncture. It should be noted that before this procedure, you need to abstain from food and water for 6 hours. During the oocyte puncture, the doctor will invite a partner to collect the material.
Then, the embryologist will start preparing the sperm cells for fertilization by the ICSI (intracytoplasmic sperm injection) method. After that, the creation of embryos begins. This process lasts 5-6 days. The embryo transfer procedure can be performed on day 3 or 5 of cultivation, depending on the selected program. After the embryo transfer procedure, patients should wait 2 weeks for the HCG test result to see whether fertilization occurs.
While this is an effective assisted reproductive technology (ART), it will not work when severe male factor infertility takes place. Make sure to consult your doctor to undergo the needed tests before you consider the procedure.
What is IVF?
IVF (in vitro fertilization) is a complex process of infertility treatment. The whole traditional IVF process is to prepare the patient for oocyte aspiration with pre-planned fertility treatment. On the appropriate day of the menstrual cycle, a procedure is performed to collect oocytes, which are then fertilized by the embryologist in the laboratory with sperm donor's material. The whole process ends with a fertilized egg and the transfer of ready-made embryos (blastocysts) into the patient's uterus.
We usually perform the embryo implantation procedure with 1 or 2 embryos (if the parents understand all the risks and are ready to have twins).
When is IVF treatment recommended?
Fallopian tube damage or blockage
Ovulation induction disorders
Previous tubal sterilization or removal
Impaired sperm production or function
A genetic disorder
Fertility preservation for cancer or other health conditions
Traditional IVF without the use of ICSI (intracytoplasmic sperm injection) is not recommended because it has lower fertilization rates and hence, is less effective. However, IVF with a donor’s sperm is recommended in case partner’s male factor infertility.
What is ICSI?
ICSI (intracytoplasmic sperm injection) is an advanced procedure of reproductive medicine that is performed in embryology and is usually part of the IVF program when male infertility has been ruled out in the couple. ICSI process implies selecting a specific sperm and injecting it with the thinnest needle into a mature egg. After this, embryos are cultured from the eggs injected with sperm.
Sperm for intracytoplasmic sperm injection (ICSI) are selected by looking at the morphology (shape) and progression (forward movement). This procedure is performed several times according to the number of oocytes obtained during the puncture — embryologists use a microscope to select only the best sperm for ICSI fertilization.
When is ICSI treatment recommended?
In case of low sperm count
When in previous attempts, no fertilization occurred without the use of the ICSI procedure
When using vitrified semen that is not of the best quality
Some men may need their sperm to be surgically extracted first
Steps of IVF with ICSI
Step 1. Ovulation induction
This stage of ICSI IVF involves preparing patients for the entire process. That is, passing tests and selecting the right fertility treatment that will be effective for specific patients. From the first day of the IVF cycle, the patient will begin stimulation. Stimulation will last under the supervision of a doctor from 9 to 13 days.
Step 2. Egg retrieval
Oocyte collection is performed under local anesthesia. Before that, patients are consulted by an anesthesiologist to avoid unforeseen situations. The procedure itself lasts from 30 to 50 minutes. Before it, patients need to abstain from food and water for 6 hours. After the ICSI IVF procedure, patients usually remain in the ward for approximately 2 more hours.
Step 3. Sperm retrieval
Sperm collection for fertilization takes place simultaneously with the procedure of oocyte puncture — the embryologist takes the material in a separate room. Sperm that is already frozen can also be used. In these cases, embryologists carry out the process of vitrification.
Step 4. Fertilization
After preparing the oocytes and sperm, embryologists begin the process of fertilization. Then, single sperm is injected directly into the mature egg. The fertilized eggs later turn into zygotes and blastocysts.
Step 5. Embryo transfer
The embryo procedure takes place on the 5th day of embryo culture when they reach the blastocysts stage. Before the procedure, preimplantation genetic testing takes place to ensure embryo quality. Patients need to have a full bladder during the procedure, which takes approximately 15-20 minutes.
Step 6. Results
The result of the program should be checked in 2 weeks. This is usually an HCG blood test. If you have any concerns (discharge or pain) for 2 weeks, you should contact a doctor immediately.
IVF with ICSI success rate
The outcome of the program is highly dependent on several factors, like the age of the patients, the cause of infertility and the results of the tests. To understand the success of a particular case, it is better to arrange a free consultation with a doctor.
In addition, the fact that ICSI is ineffective in the case of male factor infertility needs to be pointed out — alternative assisted reproductive technology should be considered.
One of the risks of such treatment is multiple pregnancies. We do not recommend transferring more than 1-2 embryos.
Ovarian hyperstimulation syndrome. The selection of medications should be discussed in detail with your doctor because if the dosage is too high specifically for this patient, it can cause symptoms of hyperovulation induction.
Miscarriage. The rate of miscarriage for women who conceive using IVF with fresh embryos is similar to that of women who conceive naturally — about 15% to 25% — but the rate increases with maternal age.
Stress. The IVF treatment with intracytoplasmic sperm injection (ICSI) is complex and requires a lot of attention and support. We advise patients not to be afraid and ask for support from their partners and relatives. This will reduce stress and increase the chances of pregnancy.
Cost of IVF with ICSI
In general, the cost of IVF+ICSI varies from 1,500 to 3,600 euros. It all depends on the plan you choose. The cost of medication to stimulate the ovaries will cost approximately 1,000 euros additionally (depending on the type of medication and its quantity).
Our IFG agency wants to offer you our plan - Standart IVF+ICSI with own eggs - 2,600 EUR.