Intracytoplasmic Sperm Injection
Intracytoplasmic sperm injection is a type of ART and its different from IVF in which a single sperm cell injected directly into the cytoplasm of an egg. ICSI revolutionised the treatment for male factor infertility. This is mainly used for very low abnormal sperm count (or) Nil sperm count from retrieved sperm cells from the Male Reproductive Tract. ICSI is generally performed following a transvaginal oocyte retrieval procedure to extract eggs from a woman.
In ICSI IVF, the male partner provides a sperm sample in case of a very low count. In the case of azoospermia, the doctor will extract the sperm from epididymis or testicle. The extraction of sperm from epidiymis is called Percutaneous Epididymal Sperm Aspiration (PESA)and MESA(Micro Epididymal Sperm Aspiration) extraction of sperm from the testicle is also known as Testicular Sperm Aspiration (TESA), Testicular Sperm Extraction( TESE). Depending on the total amount of spermatozoa in the semen sample, it can be washed or capacitated via swim-up or gradient techniques used for ICSI.
The procedure is done under a microscope using micromanipulation devices(micromanipulator, microinjector and micropipettes). A holding pipettes stabilizes the mature oocyte with gentle suction applied by a micropipette. From the opposite side a thin, hollow glass microinjector is used to collect a single sperm having immobilised it by cutting its tails. The oocyte is pierced through the oolemma and the sperm is directed into the inner part of the oocyte with the microinjector(cytoplasm). The sperm is then released into the oocyte. After the procedure, the oocyte will be placed in the special culture media in the incubator and checked on the following day for signs of fertilization.
The embryo allowed to grow in the special culture media in the incubator for 5 days. The 6th day it was kept inside the uterus called embryo transfer.
The success rate of IVF is 25% to 30% per cycle.Cumulative success rate is 80%.