ICSI-IVF is a specialized form of in vitro fertilization, which is most commonly used in many cases where severe male infertility is after that many repeated failed fertilization attempts with conventional or sometimes unconventional IVF, or after the process of egg freezing (oocyte preservation). ICSI process stands for the full form of intracytoplasmic sperm injection.

During the regular or common IVF, many of the sperms are placed together with an egg in the very hope that one of the following sperm will enter and fertilize the egg on its own without the use of the ICSI process. With the ICSI process, the prescribed embryologist will just take a single sperm and inject it directly into an egg.

Why is this ICSI process done?

ICSI process is typically done for cases which have severe male infertility, including certain factors which are as follows:-

• Comparative low sperm count (oligospermia)
• The abnormal shape of sperm (teratozoospermia)
• The movement of sperm is poor ( asthenozoospermia)

If, by chance, a man does not have any sperm present in his ejaculate but can produce sperms, they can be again retrieved through testicular sperm extraction or TESE. Sperm retrieved through this process of TESE will again require the use of the ICSI process. The ICSI process is used for cases in which retrograde ejaculation is there in which the sperm are retrieved from the man's urine.

Sometimes male infertility isn't the only reason why the ICSI process is used. There are certain other evidence-based reasons for the including of the ICSI process :

Previous IVF cycles might not have any fertilized eggs. Sometimes, there is a possibility of a good number of eggs, and the sperm count looks healthy, but unfortunately, no eggs are fertilized. In such a case, during the next IVF cycle, the ICSI process can be tried too.

Frozen sperm are also being used. If, by chance, the thawed sperms don't appear, especially the active ones, the ICSI process or IVF may be recommended.

Frozen oocytes are also used: Vitrification of eggs can cause the hardening of the egg's shell. This will further complicate the process of fertilization, and then IVF, along with the ICSI process, will help overcome this hurdle.

PGD is being done, which is a preimplantation genetic diagnosis. It is an IVF technology that is allowing genetic screening of embryos. There is a concern here that regular fertilization techniques may cause sperm cells (who will not be having the capacity to fertilize the egg) to allow "hanging around" the embryo. That may also interfere with the accurate PGD results.

IVM (in vitro maturation) is again an IVF technology where the eggs are retrieved from the ovaries before they mature completely. They will go through the final stages of maturation in their required laboratory.

Some of the researchers say that IVM eggs may not become fully fertilized by sperm cells, which are at a rate comparable to the traditional IVF method. More research is needed here, but anyway it may be that IVF with ICSI process is a good option.

Exceptions exist everywhere, here are some situations where IVF and ICSI process, may not give warranted results:

• A few eggs are only retrieved: However, the researchers haven't found that the pregnancy or live birth rates are much improved when the ICSI process is used.

• Unexplained infertility process: The logic behind the ICSI process is basically to treat the unexplained infertility cause. Research has also said that there are no signs found that the ICSI process for unexplained infertility will significantly improve the live birth success rates.

• Advanced maternal age: There is no present evidence that advanced maternal age impacts the cause of fertilization rates. Therefore, the ICSI process is not necessary.

The ICSI process is done as a part of the IVF process. Since the ICSI process is done in the laboratory, hence your IVF treatment will not seem much different than the actual IVF treatment without the ICSI process.

As per the regular IVF method, you will take ovarian stimulating drugs prescribed by the best IVF center in Noida. Then, the doctor will keep monitoring your progress with many blood tests and ultrasounds. Once you have grown enough good-sized follicles, you will have to help the egg retrieval process, where the eggs will be removed from your ovaries using a specialized and ultrasound-guided needle.

Once your eggs are properly retrieved, an embryologist will place the eggs in a special culture by using a microscope along with a tiny needle; your single sperm will be injected into an egg. This ICSI process will be done for each egg retrieved.

The ICSI process results in the fertilization of 50 to 80 percent of the eggs. You might be assuming that all such eggs are getting fertilized with the ICSI process, but they don't. Fertilization isn't a guaranteed method even when a sperm is manually injected into the egg.

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