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What is ICSI?

Intracytoplasmic sperm injection (ICSI) is an in vitro fertilization technique where sperm is directly injected into the egg. In some cases, the sperm needs to be extracted from the man first with surgery.

Why is ICSI performed?

ISCI is carried out to treat cases of male infertility, including cases of:

• oligozoospermia - low concentration of sperm
• azoospermia - absence of sperm
• teratozoospermia - few spermatozoids with poor shape
• asthenozoospermia - low mobility

What happens during ICSI?

The steps to follow are:

• Controlled ovarian stimulation: the woman receives a hormonal treatment with medication for approximately 10 days. This is done to stimulate the production of ovules and obtain a greater quantity of eggs. This medication also makes it possible to control the time of ovulation and thus increase the chances that the eggs obtained are suitable for fertilization.
• Ovarian or follicular puncture: this is a surgical procedure that consists of extracting the mature ovules from the ovary. The process is carried out by aspiration under anesthesia and sedation and lasts between 20 and 30 minutes.
• Decumulation: the liquid obtained in the puncture is analyzed in search of eggs. After a time of rest, the cells that may be present are removed.
• Collection and preparation of semen: this consists of collecting the male sample and passing it through a process of sperm training so that the sperm are able to fertilize the ovule and produce an embryo.
• Insemination: sperm is chosen, aspirated with the microinjection needle and introduced into the egg by means of a micropipette, waiting for fertilization to occur.
• Embryo culture: after fertilization, the embryos are allowed to continue their development in the incubator, which maintains optimal conditions of humidity, light and temperature for embryonic growth.
• Endometrial preparation: the patient is administered estrogen and progesterone vaginally, orally or in patches to ensure that their uterine cavity is in the best conditions for embryonic development.
• Embryo transfer: between one and three embryos are selected to be transferred to the maternal womb. It consists of introducing a catheter in the vagina to deposit the embryos in the uterine fundus and wait for them to implant in the endometrium and start the pregnancy. This step is very simple, lasts a few minutes and does not require anesthesia.
• Embryo freezing: non-transferred quality embryos are cryopreserved for later use.

Aftercare

After the transfer of embryos, the patient has to rest in the clinic for 30 minutes and then she can return home, although it is recommended to avoid intense physical exercise.

It is also advisable to drink plenty of fluids, restrict salt intake, avoid sexual intercourse until the pregnancy test, and avoid immersion baths in hot water.