INTRACYTOPLASMIC SPERM INJECTION (ICSI)
It is a process where in a sperm is injected via in vitro fertilization technique. This is required whence the sperm count in the male is very low. In ICSI a single sperm is injected in to the egg. If sperms are absent in ejaculate the extraction can take place directly from the testis. This is also known as testicular sperm extraction. It requires a micro manipulator which holds the egg by suction. Following this a sharp needle used to inject a single sperm to achieve fertilization. This technique is a boon for couples whence conventional IVF is not successful. This happens when the sperm count is very low or the sperms are non motile.

HOW ICSI IS CARRIED IN OUR FERTILITY CLINIC?
Like conventional IVF the stimulation protocol for the ICSI is similar. The egg removal is surgical as it is done in IVF. Normally eggs are covered by cell cluster referred to as cumulus corona cells. These cells must be removed completely before the sperm injection succeeds. The removal gives an insight of the egg to embryologist in order to assess the maturity of the egg. Sperms are collected from male partner either through semen or are surgically retrieved from testis (Testicular sperm extraction and ICSI- TESE-ICSI, Percutaneous sperm aspiration- PESA- ICSI).

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The retrieved eggs are placed in a dish and subjected to 200 or 400 times magnification using an inverted microscope which is fitted with the micro manipulator. The clinic has Nikon Narishige combinations which are of superior quality. The egg which is approximately 100 micron in width is held by a glass holding pipette which has a diameter of forty to fifty microns usually on the left side. The injection needle has a diameter of 5 to 6 micron.

In ICSI the sperms are immobilized using a chemical called PVP or by hitting the sperm's tail and then loaded in the injection pipette. Injection is completed in a minute's time with help of fine movements of micro manipulator. In the whole process it is the expertise of the embryologist which results in success. Consequently fertilization is checked after sixteen to eighteen hrs of injection.

Results: In case ICSI fertilization is achieved with about 65 % success. Even though sperms are injected inside the egg by experts 100 % fusion of both the gametes is not expected.

Blastocyst Transfer : Resulted fertilized eggs ( embryos ) are grown in reduced oxygen atmosphere in an incubator for 5 to 6 days. They are grown upto partially hatched blastocysts & then atraumatically transferred into the uterus.

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