Infertility can be emotionally challenging for couples, especially when male factor infertility plays a role. Advances in assisted reproductive technology (ART) have made parenthood possible even in complex cases. One of the most effective treatments available today is Intracytoplasmic Sperm Injection, commonly known as ICSI. This method is widely used to overcome issues such as low sperm count, poor motility, or abnormal sperm shape. To understand how it works, let’s explore the step-by-step process of the ICSI procedure in detail.
Step 1: Initial Consultation and Fertility Assessment
The journey begins with a detailed consultation with a fertility specialist. Both partners undergo a comprehensive medical evaluation that includes medical history, physical examination, and diagnostic tests.
For men, semen analysis is performed to check sperm count, motility, and morphology. If azoospermia or very low sperm count is detected, further tests such as hormonal profiling or genetic analysis may be advised. Women undergo ultrasound scans and hormonal tests to assess ovarian reserve and reproductive health.
This initial step helps the doctor determine if ICSI is the right treatment and plan a tailored approach for the couple.
Step 2: Ovarian Stimulation
For ICSI to succeed, multiple mature eggs are required. To achieve this, the woman undergoes controlled ovarian stimulation with fertility medications. These medications encourage the ovaries to produce more eggs than they naturally would in a normal cycle.
During this stage:
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Hormone injections are given daily for around 8–12 days.
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Regular ultrasound scans and blood tests are performed to monitor follicle growth.
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Once the follicles reach the right size, a “trigger injection” of hCG or another hormone is administered to help the eggs mature.
Ovarian stimulation is a crucial step, as the number and quality of eggs retrieved directly influence the chances of success.
Step 3: Egg Retrieval (Ovum Pick-Up)
About 34–36 hours after the trigger injection, the egg retrieval procedure is carried out. This is a minor surgical procedure performed under sedation or anesthesia to ensure the patient is comfortable.
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A thin needle is guided into the ovaries through the vaginal wall using ultrasound guidance.
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The fluid from the follicles is aspirated, and the eggs are collected from this fluid.
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The procedure usually takes 20–30 minutes, and the patient can return home the same day.
The collected eggs are then placed in a special culture medium in the laboratory, where they are carefully examined by embryologists to identify mature eggs suitable for fertilization.
Step 4: Sperm Collection and Preparation
At the same time as egg retrieval, a sperm sample is collected from the male partner. If a fresh semen sample is not possible due to azoospermia or other conditions, surgical methods like TESE (Testicular Sperm Extraction) or micro-TESE may be performed to retrieve sperm directly from the testes.
Once collected, the sperm sample undergoes a preparation process. Embryologists select the healthiest and most motile sperm to maximize the chances of successful fertilization during the ICSI procedure.
Step 5: Intracytoplasmic Sperm Injection (ICSI)
This is the most critical stage of the procedure. Using a high-powered microscope and micromanipulation tools, the embryologist carefully selects a single, healthy sperm.
The sperm is injected directly into the cytoplasm of the mature egg with a fine glass needle. Unlike conventional IVF, where thousands of sperm are placed around the egg to fertilize naturally, ICSI ensures fertilization by bypassing natural barriers.
This step dramatically improves fertilization rates, especially in cases of severe male infertility.
Step 6: Fertilization and Embryo Development
After ICSI, the eggs are monitored closely in the laboratory. Within 16–20 hours, embryologists check whether fertilization has occurred.
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Successfully fertilized eggs begin dividing and developing into embryos.
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The embryos are monitored for several days, usually up to day five, to reach the blastocyst stage.
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Embryologists assess the quality of embryos based on their growth, appearance, and cell division.
This careful observation ensures that only the best-quality embryos are selected for transfer.
Step 7: Embryo Transfer
Embryo transfer is a simple, painless procedure that does not require anesthesia. Typically, one or two embryos are selected and transferred into the woman’s uterus.
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A thin catheter is used to place the embryos gently into the uterine cavity.
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The procedure takes only a few minutes and is similar to a routine gynecological exam.
The remaining high-quality embryos may be frozen for future use, giving couples additional opportunities if the first attempt is unsuccessful or if they wish to expand their family later.
Step 8: Luteal Phase Support and Monitoring
After embryo transfer, the woman is prescribed hormonal medications such as progesterone to support the uterine lining and promote implantation.
Around 12–14 days after the embryo transfer, a blood test (beta-hCG) is performed to confirm pregnancy. If positive, additional ultrasounds are scheduled to monitor early pregnancy development.
Step 9: Emotional and Psychological Support
The ICSI journey can be physically and emotionally demanding. Fertility specialists emphasize the importance of counseling and support services to help couples manage stress and anxiety during treatment. Emotional well-being is considered an essential part of the success of fertility treatment.
Conclusion:
The ICSI procedure is a step-by-step journey that combines advanced science with careful planning and emotional support. From initial consultation and ovarian stimulation to egg retrieval, sperm injection, and embryo transfer, every stage is designed to maximize the chances of fertilization and pregnancy. For couples struggling with male infertility, ICSI offers a highly effective path to parenthood, transforming challenges into hope.
For More Details: https://acimc.org/ivf-lahore/