ICSI stands for intacytoplasmic sperm injection and is indicated for severe male factor infertility (very poor sperm) and obstructive azoospermia. Steps involved are same as in IVF only difference being the method of fertilization. In ICSI each oocyte (egg) is injected with one healthy sperm. This is done under microscope with micromanipulation devices. Steps involved are as follows:
Injections are started to the female partner either from day 21 or day 2 of menstrual cycle. Follicular growth is monitored by a series of scan that help the Physician to adjust the dose of the injections accordingly. The day follicles are matured egg retrieval is planned after HCG trigger (that helps egg undergo final maturation steps and eventual ovulation).
Egg retrieval is done under GA (general anesthesia) using transvaginal ultrasound guided needle. All follicles are aspirated and examined under microscope to identify the eggs.
Each egg is individually injected with one sperm each. Embryos hence formed are incubated for a period of 3 to five days.
Day 3 or day 5 transfer is done using special catheter.
Pregnancy test is advised after 2 weeks of embryo transfer.
Semen sample is required on the day of egg retrieval. Abstinence of 2 to 6 days is advisable for the sample. Sample should be preferably produced in the centre, but if necessary could be brought from home (you will have to reach the centre within 45minutes of producing the semen sample). In some cases of male infertility, sperm would be surgically withdrawn from the testes by TESA.