IVF ICSI: Enhancing Pregnancy Success with Nakornthon Hospital

In Vitro Fertilization with ICSI: Many couples who have undergone ICSI have successfully conceived, realizing their dream of having a child. ICSI is a specialized procedure that significantly increases the likelihood of pregnancy. If you're planning to start a family, you can consult with a specialist. Nakornthon GIFT Fertility Center offers comprehensive care for fertility issues, from consultation and diagnosis to personalized treatment plans. Let's explore ICSI in detail to understand its steps and how it can help.

What is ICSI?

Intracytoplasmic Sperm Injection (ICSI) is a form of in vitro fertilization (IVF) where a single healthy sperm is directly injected into a mature egg using a fine needle. This procedure is conducted outside the body, aiding fertilization in cases where sperm count is low, sperm motility is impaired, or sperm cannot penetrate the egg naturally. ICSI is a cutting-edge medical technology designed to assist couples facing fertility challenges in achieving pregnancy.

> Back to Table of Contents

Who is ICSI Suitable For?

• Male Factor Infertility: Men with low sperm count, poor sperm quality, or severe motility issues.
• Vasectomy Cases: Men who have undergone a vasectomy but wish to father a child, with sperm retrieval possible through surgery.
• Female Egg Shell Issues: Women with thick egg shells where sperm cannot penetrate naturally, often used when traditional IVF is unsuccessful.
• Genetic Concerns: Couples needing embryo chromosome testing due to genetic disorders.
• General Infertility: Couples experiencing general difficulties conceiving.
• Advanced Maternal Age: Women aged over 35 years.

> Back to Table of Contents

Steps Involved in ICSI

1. Ovarian Stimulation

After assessing the woman's readiness for ICSI, ovarian stimulation is initiated to mature multiple eggs simultaneously. This begins on the 2nd or 3rd day of the menstrual cycle, with daily hormone injections for 8-10 days, aiming to mature 8-15 eggs.

2. Monitoring Follicle Development

The growth of follicles is monitored using ultrasound and blood tests every 4-5 days. Once the follicles are mature, a hormone injection is given to trigger final egg maturation.

3. Egg Retrieval

Eggs are retrieved 34-36 hours after maturation via a needle inserted through the vaginal wall, guided by ultrasound. The eggs are then cleaned and prepared for fertilization in the lab.

4. Sperm Collection

The male partner provides a sperm sample, which is processed to select the strongest and healthiest sperm for injection into the egg. If sperm retrieval from the testicles is necessary, this is also done at this stage.

5. Embryo Culturing

Once fertilization is achieved, the embryos are cultured in the laboratory, a process known as Blastocyst Culture. This involves nurturing the embryos outside the body in a controlled environment for 3-5 days. The laboratory environment is meticulously managed to replicate the conditions within the human body, ensuring that the embryos develop under optimal conditions.

The embryos are cultured in a specialized medium that supports their growth, inside incubators where temperature, humidity, pH, and gas levels are carefully regulated. The aim is to create conditions as close as possible to those within the uterus, allowing the embryos to develop until they reach the Blastocyst stage—about 5 days post-fertilization. At this stage, the embryo consists of hundreds of cells and is considered strong and viable for implantation.

Before transferring the embryos back into the uterus, embryologists evaluate them based on their developmental progress. They may also perform Preimplantation Genetic Testing (PGT). During PGT, a small sample of cells (5-10 cells) is taken from the trophectoderm, the part of the embryo that will eventually form the placenta. This testing helps identify any chromosomal abnormalities or genetic disorders, ensuring only healthy embryos are selected for transfer.

Using ICSI in conjunction with PGT allows couples to select embryos with normal chromosomes or only recessive genes, thereby increasing the chances of a successful pregnancy with each transfer cycle. This careful selection process, along with the advanced technology used in the lab, significantly enhances the likelihood of a healthy pregnancy.

6. Embryo Transfer:

The final step in the ICSI process is the transfer of the embryos back into the uterus, a critical phase that involves placing the selected embryos into the uterine cavity. This procedure is performed using a fine plastic catheter, which is gently inserted through the cervix into the uterus under ultrasound guidance to ensure precise placement of the embryos.

There are two main approaches to embryo transfer:

1. Fresh Embryo Transfer: This occurs in the same cycle as the egg retrieval and embryo culture. After 3-5 days of culturing, the best quality embryo(s) are selected and transferred into the uterus. The timing is carefully coordinated to align with the endometrium's readiness to receive the embryo, maximizing the chances of successful implantation.
2. Frozen Embryo Transfer (FET): In cases where the uterine environment is not optimal during the initial cycle, or when genetic testing results are pending, the embryos can be frozen and preserved for future use. This method allows flexibility in timing and can be performed in subsequent cycles when the hormonal conditions and endometrial thickness are ideal. Frozen embryos can be stored for 5-10 years, providing multiple opportunities for implantation.

Before the transfer, doctors assess the uterus and hormone levels to determine the most suitable approach—fresh or frozen. If the embryos were genetically tested, freezing is often necessary to await the results, ensuring that only the healthiest embryos are transferred.

Pregnancy Test:

9-11 days after the embryo transfer, a blood test is conducted to check for pregnancy. Home urine tests are not recommended due to the potential for inaccurate results.

> Back to Table of Contents

Post-Embryo Transfer Care

Following the embryo transfer, it's important for the woman to rest for at least 15-20 minutes. Avoid sexual intercourse, vaginal douching, strenuous exercise, and heavy lifting to support embryo implantation. Strictly follow your doctor’s advice, and seek medical attention if any unusual symptoms occur.

ICSI is currently one of the most successful fertility treatments available. However, the success rate varies depending on individual factors such as age and health. Women under 35 have a 40-50% chance of pregnancy, while those over 35 who undergo chromosomal testing may see their chances rise to 50-75%.

> Back to Table of Contents

For more information

For couples interested in or seeking more information about ICSI, Nakornthon GIFT Fertility Center is ready to assist. Our team of experts is available for consultations to help guide you through the process. Feel free to reach out; we're here to help.