Get Free Treatment QuoteGet Free Treatment Quote
Get a call backGet a call back

Healthcaretripindia.com

ICSI (Intra Cytoplasmic Sperm Injection)

ICSI Infertility treatment in India

ICSI (Intra Cytoplasmic Sperm Injection)

Package Cost : On request

Send Enquiry

View Photos

Revolutionary treatment for male sperm related infertility that involves injecting single healthy sperm into mature egg followed by placement of the fertilized egg into the women's womb. It is one of the assisted reproductive technology that helps an infertile couple to bring a healthy baby into this world. It is paramount that each couple should take consultation and undergo thorough examination to determine, along with their specialist, the most appropriate treatment method that will bring about good results. Since fertilization of egg takes place outside the woman's body, it is considered as a form of IVF (In vitro fertilization). It is regarded as one of the best male infertility treatment.

Q1. What is Infertility?

 

A1 Inferility is defined as the inability to conceive even after one year of regular(once in every 2 to 3 days) unprotected sex i.e., without utilizing any method of contraception. According to statistics, generally around 85% of the couples conceive within an year of regular unprotected sex, however, in United Kingdom, infertility is only diagnosed if there is an inability to conceive even after 2 years or 24 months of regular unprotected sex, without contraception. According to the data provided by National Health Service, UK, 95% of the couples will conceive by 2 years. Infertility may be due to innate inability of one of the partner to contribute his/her bit in conception or even when the female is not able to carry the pregnancy to the full term.

 

Pregnancy happens when:

  • Egg or ovum (female reproductive cell) is released by one of woman's ovaries.(Ovulation)

  • Sperm or male reproductive cell unites with ovum.(Fertilization)

  • Fertilized egg travels through the fallopian tube until it reaches the uterus(womb).

  • Fertilized egg adheres to the uterine wall.(Implantation)

Problem with one or more of the above milestones in the pregnancy process, may result in infertility.

 

Q2 What are the types of infertility?

 

A2 There are mainly two types of infertility.

 

Primary Infertility: Primary Infertility term is used for the couples who have not been able to conceive at least once, even after an year of regular unprotected sex, without contraception.

 

Secondary Infertility: Secondary infertility term is used for the couples who were previously able to have their own, one or more biological child/children naturally but are inable to conceive now or carry the pregnancy to the full term.

 

Q3 I have a child. However, I am not able to conceive again. What could be the reason?

 

A3 Secondary infertility, which seems to be your case, may be caused by the following:

 

  • Problem with the formation, function and delivery of sperms.

  • Disorders of fallopian tube, uterus

  • Problem with the Ovulation

  • Endometriosis

  • Complications associated with previous surgery or pregnancy

  • Could be as a result of certain medications

 

Q4 What makes a man vulnerable to development of infertility?

 

A4 The several factors that makes a man vulnerable to development of infertility can be summarized as follows:

  • Smoking

  • Obesity or being overweight

  • Age also to some extent, though not as important a factor as in females

  • Excessive alcohol intake

  • Increased exposure to radiation, high temperature, environmental toxins

  • Side effect of certain medications

 

Q5 Is infertility only a woman's problem?

 

A5 Its purely a misconception that women are the only ones who are responsible for infertility. Its imperative to make it clear that man and a woman have their own respective parts to play in conceiving a child and anyone of them or both may be responsible for the infertility. 

 

 

Q6 What are the causes of male infertility?

 

A6 There are several causes responsible for male infertility. Semen analysis is carried out initially to determine whether male factor is responsible for infertility and if yes, then how and accordingly further course of action is planned by the specialist. Semen analysis looks into the appropriate concentration of sperms(number), their functional capacity(motility) and their structure(shape). The responsible causes of male infertility work by affecting sperm production, their quality (structure,motility,viability) and delivery. They can be summarized as follows:

 

Impaired testicular function or ejaculation 

 

  • Varicocele(abnormal enlargement of veins in the scrotum, the loose bag of skin in which the testes are present). It causes the testes to overheat which not only leads to low sperm production but also adversely affects their quality.​

  • Injury to the testes

  • History of Undescended testicles or cryptorchidism

  • Indiscriminate use of alcohol,excessive smoking, use of anabolic steroids or use of illicit drugs are some of the detrimental habits.

  • Certain medications or summplements also adversely affects the male fertility.

  • May be a result of cancer treatment such as chemotherapy, radiation therapy or surgical treatment that involves removal of one or both the testicles.

  • Certain medical conditions may adversely affect testes such as Diabetes, Cyctic Fibrosis, some autoimmune disorders and infections such as Gonorrhoea, Chlamydia.

  • ​Sperm delivery is compromised due to 

    • Blockage or damage resulting from injury or diseased condition of the reproductive organs in males.
    • Genetic defects such as Cystic Fibrosis that results in abnormal development or absence of vas deferens, epididymidis(the muscular tubes that stores and transports sperm from the testes to the ejaculatory ducts).
    • Premature Ejaculation

Hormonal problems

 

  • Disorders of hypothalamus and pituitary gland leading to impaired testicular function. Prolactin secreting Pituitary tumor leads to increased production of hormone Prolactin, a condition referred to as Hyperprolactinemia which causes loss of libido, impaired sperm production, impotence. Hypothalamus and Pituitary gland in the brain produce hormones that are responsible for the normal function of the testes.

  • Congenital adrenal hyperplasia

  • Cushing's syndrome

 

Genetic conditions

 

  • Klinefelter's syndrome, Y chromosome microdeletion are some of the genetic disorders that result in low or no sperm production.

 

Q7 What are the causes of infertility in woman?

 

A7 Female infertility can be attributed to the disorders of one or more of the following:the ovaries, fallopian tubes and uterus. 

 

They need to be healthy and fully functional. The causes can be summarized as below:

 

  • Impaired ovarian function wherein release of the egg from the ovaries(ovulation) is affected. It may be due to

    • Polycystic Ovary Syndrome(PCOS): A medical condition characterized by development of several fluid filled sacs(cysts) in the ovaries. It is one of the most common reason for female infertility and is treatable. It is associated with hormonal imbalances leading to anovulation or irregular ovulation (release of eggs from the ovaries) indicated by irregular or no periods, weight gain, fertility issues and depression. It is also associated with increased level of male hormone (testosterone) responsible for acne, excess hair growth(hirsuitism) and hair thinning on the scalp. 

    • Diminished ovarian reserve (DOR): Every women is born with all the eggs she will ever have in her lifetime. As she ages, the number of eggs decrease naturally. However, there are various other congenital, medical, surgical or unknown causes responsible for abnormally low number of remaining eggs in the ovaries. As the condition's name implies, diminished ovarian reserve means that there are less number of eggs left in the ovaries. Women with DOR may conceive naturally, however, their response to the fertility treatment may result in production of less number of eggs.

    • Functional Hypothalamic Amenorrhoea (FHA), a condition resulting from a lot of exercise, stress or extremely low body weight. It sometimes accompany eating disorders such as anorexia (loss of appetite).

    • Inefficient functioning of hypothalamus and pituitary gland in the brain- Hormones released by hypothalamus and pituitary gland are responsible for the normal function of ovaries and release of eggs from them. However, in a medical condition Hyperprolactinemia, which is characterized by high production of hormone prolactin from the pituitary gland, woman may not ovulate.

    • Premature Ovarian Insufficiency (POI), also referred to as Premature menopause, wherein ovaries stop functioning even before 40 yrs of woman's age i.e., far earlier than the age when normal menopause sets in. Although there are certain conditions that makes a woman susceptible to POI, such as chemotherapy or pelvic irradiation exposure or certain medical conditions. Usually the cause is unknown.

    • Menopause, a normal phase of woman's life that sets in around 50 yrs of her age and is characterized by normal decline of ovarian function, hormones estrogen and progesterone are no longer produced by the ovaries and cessation of menstruation or periods. Once menopause begins, she is no longer able to conceive naturally. Menopause is considered to have set in if periods have not occurred for one whole year.

  • Fallopian tube obstruction: A pair of thin and long muscular tubes in the abdominal cavity of the woman that extends from the ovaries to the uterus. Fully functional,normal, open and unobstructed fallopian or uterine tubes are paramount in successful spontaneous reproduction. They play a significant role in transport of reproductive cells(ovum and sperm), provide favorable environment for fertilization of egg and early embryo development. There are various tubal elements that come into play to make the tube work efficiently. They are rhythmic muscular contraction of the tube, ciliary function(thin hair like projections on the inside of the walls of the fallopian tube) and tubal secretions. History of pelvic infection, abdominal surgery, ruptured appendicitis, Chlamydia or Gonorrhea infection or endometriosis may point towards tubal blockage or occlusion.

  • Uterus disorders such as uterine fibroids that distort the uterine cavity and make it difficult for implantation to take place. However, they are treatable. Scarring or adhesions within the uterus or malformation of the uterus are some other causes for female infertility.

Q8 What are the treatment options for infertiity?

 

A8 Infertility can be treated with the administration of medicines, surgery, IUI (Intrauterine Insemination) and ART(Assisted Reproduction Technology). Several factors are taken into account before determining the best treatment protocol for the couple. The factors are:

  • Cause of the infertility

  • Duration of infertility

  • Woman's age

  • and the couple's treatment method preference

​Normally, thorough evaluation and counselling are done regarding viability, pros and cons of each treatment option, their success rates before reaching the final treatment decision after mutual consent.

 

Q9 What is ART(Assisted Reproduction Technology)?

 

A9 ART or Assisted Reproduction technology or treatment, as the name implies, refers to the use of technology in order to assist in achieving pregnancy. ART or Assisted Reproduction technology encompasses broad range of fertility treatments such as:

 

  •  IVF (In vitro Fertilization): The most common and most successful form of ART, which refers to fertilization that takes place outside the woman's body, in a laboratory. The egg from the female partner and the sperm from the male partner are procured and united in a laboratory and the resulting embryo after 3 to 5 days of development, is transferred back to the uterus(womb).

  • ICSI(Intracytoplasmic Sperm Injection)- a form of IVF procedure which is carried out to overcome the male infertility factor and it involves injecting single healthy sperm into a mature egg in contrast to traditional fertilization method wherein the egg and several sperms are placed together for the sperm to fertilize the egg on its own.

  • ​ZIFT (Zygote Intra Fallopian Transfer), nearly obsolete older form of ART, also referred to as Tubal Embryo Transfer in which although fertilization takes place outside the woman's body but the embryo is transferred into the fallopian tubes instead of the uterus, unlike conventional IVF. This can be considered as IVF variant.

  • GIFT (Gamete Intra fallopian transfer), also an older form of ART, used rarely now a days. Here, fertilization takes place in the woman's body, however, the sperm and ovum are transferred to the fallopian tube for fertilization to take place.

ART may use donor eggs, donor sperms or frozen embryos. Donor eggs are procured from another woman in order to overcome infertility issues of the woman who has no egg of her own to contribute for conception.

ART may involve surrogate or gestational carrier.  Contrary to the popular belief, surrogate and gestational carrier are two different entities.

A surrogate is a woman who donates her egg and gets pregnant from the sperm of the male partner of the infertile couple and carry the pregnancy, in other words, she is biologically related to the child she is carrying whereas a gestational carrier is not biologically related to the child she is pregnant with, she becomes pregnant from egg from the female partner and sperm from the male partner of the infertile couple. Egg or the sperm could be from the donor also procured through the process of IVF. Gestational carrier just carries the pregnancy of the fertilized embryo till term, for another infertile couple.

 

Q10  What are the indications for opting for Gestational carrier?

 

A10 Gestational carrier may be considered in case all other fertility treatment options have failed to show some success and there are medical reasons that prove Gestational carrier to be the only viable option for the infertile couple.

 

A woman who has had her uterus removed surgically due to presence of uterine or cervical cancer, uterine fibroids and severe endometriosis or purely a dysfunctional uterus may opt for a gestational carrier. Heart and other medical ailments that makes the woman vulnerable to developing complications during pregnancy to an extent that pregnancy becomes dangerous to the life of mother as well as the child, they may also consider gestational carrier. The only prerequisite is that the female's ovaries should be healthy and functional to render an egg that can be fertilized through the male partner's sperm or donor sperm and she can be a biological mother to that baby carried by a gestational carrier to full term.

 

 

Q11 What is IVF?

 

A11 IVF stands for In Vitro fertilization. Fertilization of egg that takes place outside the woman's body. It is a type of ART(Assisted reproductive technology) that involves retrieval of a healthy egg(female reproductive cell) and a healthy sperm(male reproductive cell) and fusing them together outside the woman's body, in a lab dish, thereafter transferring the fertilized egg back into the womb(uterus).

 

Q12 What is ICSI?

 

A12 ICSI stands for Intra Cytoplasmic Sperm Injection. It is a form of IVF(In vitro fertilization) procedure in which a single healthy sperm is selected by an embryologist and directly injected into mature egg for fertilization to take place unlike conventional method wherein many sperms are placed together with the egg in a lab dish and left to fertilize the egg on its own. It is one of the most common in vitro fertilization method which has given high success rates. It is used to treat the male infertility issues.

 

Q13 What are the indications for ICSI?

 

A13 Intra Cytoplasmic Sperm Injection, ICSI is recommended for the infertile couple with severe issues with male fertility involving sperms (quantity and quality)and their fertilizing capacity, such as 

  • Very low sperm count(Oligozoospermia)

  • Poor quality of the sperms(shape and motility)-Weak motility of sperms(Asthenozoospermia), Abnormal sperms (Teratozoospermia)

  • Anti sperm antibodies

  • Vasectomy

  • Obstruction in Vas deferens

  • Failed attempt at vasectomy reversal

  • Unsuccessful fertilization(no or poor) with conventional IVF

  • Using surgical technique to procure sperms from the testicles or the epididymis( a narrow thin tube where sperms are stored and matured and it is located in the scrotum). Surgical retrieval of sperms is done when sperms are not present in the ejaculate (vasectomy) or you have extremely low sperm production.

  • In case of frozen sperm being used which is not of suitable quality.

 

Q14 How is ICSI done?

 

A14 Before you begin your treatment with your consent, which involves doing some paper work, several tests would be done in order to screen you and your partner, if need be, for presence of HIV, Hepatitis B and Hepatitis C, HTLV I and II(Human T cell Lymphotropic virus).

 

Treatment consists of the following stages:

 

In case of woman

You will be given fertility drugs in order to stimulate your ovaries so that more eggs are produced. Progress is monitored through repeated vaginal ultrasound and certain blood tests. Subsequently, your eggs are collected and each egg is injected by the sperm from your partner or possible donor. Your specialist may recommend SET(Single embryo transfer), if deemed suitable as you are more likely to have twins or triplets if more than one embryo is transferred.

 

In case of man

 

Your specialist will determine if you are able to provide a sperm without any surgical intervention.

 

If yes,

 

Sperm is procured from fresh sample collected on the same day of egg collection from your partner.

 

If no,

 

Sperms retrieval techniques can be adopted such as 

 

  • PESA-Percutaneous Epididymal Sperm Aspiration that involves sperm retrieval from epididymis through a fine needle.
  • TESA-Testicular Sperm Aspiration that involves sperm retrieval from the testes.
  • TESE-Testicular Sperm Extraction that involves extraction of sperms from the small amount of testicular tissue that has been removed.
  • Frozen stored sperm can also be used after its preparation for the treatment.

​Actual procedure

 

Single sperm is subsequently injected into each egg. Sperm is selected after thorough examination done under specialized microscope by the embryologist. Sperm is suctioned into the injection followed by penetration of the egg by the injection and release of sperm into the egg. The whole process is done under the special microscope. The injected egg is checked for the hints of fertilization after around 16 hrs and if fertilized, it is placed in culture. i.e., after fertilization, if it happens, the resulting embryo/s are allowed to develop for another 5 to 6 days under favorable environment and the best (one to three) out of them are transferred to the womb. 

 

In case of no sperms available either due to vasectomy or otherwise, you can still take a chance with surgical retrieval of sperms through one of the above mentioned techniques PESA, TESA or TESE, although results are not so promising. If the techniques prove futile in procuring sperm, you may wish to consider donor insemination or IVF using donor sperm. 

 

 

 

 

 

 

 

Benefits of Infertility treatment in India

 

  • High and consistent success rate

  • World class, state of the art IVF centres in India, well equipped with the latest technology

  • No waiting period

  • High quality treatment at the most affordable cost

  • Globally trained and highly experienced IVF specialists

  • Great ambience

  • Compassionate staff to look after

  • Accredited with international organizations such as JCI(Joint commission International) for quality standards.

  • Language no barrier. English speaking people and if required, translators are available for your convenience

  • Most economical accommodation available at a walking distance from the hospital. Wide range of options starting from guest house, service apartments to five star hotels, best suited to your budget and choice.

  • Good flight connectivity

  • India has a diverse and rich cultural heritage. You can witness its beauty and uniqueness. It offers most conducive environment for recuperation.

 

Dr. Hrishikesh D. Pai

MD, FCPS, FICOG, M.Sc (USA)

Director, Bloom IVF group

President of ISAR(Indian Society for Assisted Reproduction)

Secretary General of FOGSI(Federation of Obstetric and Gynecological Societies of India)

 

Dr. Nandita Palshetkar

MD, FCPS, FICOG

Director, Bloom IVF group

Hon. Secretary of ISAR (Indian Society for Assisted Reproduction)

Vice President of MOGS (Mumbai Obstetrics and Gynecological Society)

 

Photos

Browse All Hospitals

Hospitals

bdr line

  • Gurgaon,Delhi-NCR

    One of India's largest multi-super specialty institutes founded by Dr Naresh Trehan, the eminent cardiac surgeon. The institutes expands over an area of 43 acres and has a research cente

    View Details

  • Saket, New Delhi

    Max healthcare is a leading group of super specialty hospitals in India with over 8 hospitals in Delhi, 1500 physicians, 3000 support staff and 800 beds.World class infrastructure,services in more tha

    View Details

  • Noida, Delhi-NCR

    NABH accredited, 1200 bedded flagship hospital of the Jaypee Group, is a tertiary care multi specialty hospital with the state of the art infrastructure, over 400 highly skilled globally trained docto

    View Details

  • New Delhi

    The pioneer of integrated healthcare, operates chain of 64 Super specialty hospitals with capacity of over 10,000 beds,over 7000 doctors and over 56 different specialties to cater to patient's nee

    View Details

  • Gurgaon;Bangalore

    Columbia Asia, a multi-national healthcare provider operating chain of 12 multi-disciplinary tertiary care hospitals in India, has set a benchmark in the field of transplantation (Kidney,Intestine,Liv

    View Details

  • Mumbai,India

    JCI accredited tertiary care multi super specialty hospital with latest technology, multi disciplinary capabilities, state of the art infrastructure, world class facilities and outstanding patient car

    View Details

  • Kozhikode(Calicut), Kerala, India

    NABH accredited 800 bedded multispeciality tertiary care hospital established in 1987, with state of the art infrastructure and equipped with most advanced technology. Since the time of its inception

    View Details

  • Delhi,India

    Asia's largest healthcare group "Apollo Hospital Group" expanded its footprint that comes under the banner of Apollo Spectra hospitals. Multi specialty group of hospitals that follo

    View Details

  • New Delhi, India

    Fully dedicated 150 bedded Super Speciality Tertiary Care Children's hospital exclusively built keeping all the nuances of child healthcare in mind. Rainbow Group, the nation's leading childre

    View Details