IVF/ICSI are some of the most sought-after treatments because they offer high chances of pregnancy.

What is ICSI?

This is a technique performed during In Vitro Fertilization (IVF) that involves injecting a sperm cell directly into an egg using a specialized pipette to aid fertilization.

To do this, the male must provide a semen sample or undergo a testicular biopsy, if necessary, to select the best sperm. The goal of this technique is to assist sperm that cannot reach the egg on their own. This way, the chances of fertilization and, consequently, pregnancy are increased. It’s typically only necessary when sperm have poor morphology and/or motility.

When is ICSI recommended?

  • Low sperm count or mobility issues.
  • Previous vasectomy.
  • Infectious disease or immune-related infertility.
  • Difficulty achieving normal ejaculation, as in retrograde ejaculation.
  • Cases of cryopreserved samples from vasectomized men or those undergoing radio or chemotherapy treatment. These are valuable samples due to their limited quantity, and ICSI optimizes their use.
  • Multiple unsuccessful attempts at IVF and IUI.
  • Low number of eggs obtained after retrieval.
  • When Preimplantation Genetic Testing (PGT) is performed to select embryos without genetic/hereditary diseases.
  • A low number of sperm is perceived, or mobility problems
  • Has previously had a vasectomy
  • You have an infectious disease or infertility of immunological cause
  • Difficulty achieving ejaculation under normal conditions, as occurs in retrograde ejaculation.
  • Cases of cryopreserved samples from vasectomized men or men undergoing radiotherapy or chemotherapy. They are very valuable samples because a limited quantity is available and ICSI allows their use to be optimized.
  • When multiple IVF and AI attempts were unsuccessful
  • When after the puncture the number of oocytes is very low
  • In those cases in which Preimplantation Genetic Testing (PGT) is performed to select healthy embryos without genetic/hereditary diseases

How does the procedure work?

At WeFIV, we conduct a personalized assessment of each patient to determine the most suitable assisted reproduction treatment. If IVF with ICSI is recommended, ovarian stimulation is initiated, aiming to retrieve a good number of eggs for IVF . Egg retrieval is carried out in all IVF treatments, whether or not ICSI is needed, and involves self-administering daily injections to prompt the ovaries to produce more eggs instead of just one. This way, more embryos can be obtained to select the best one in terms of morphology and development for achieving pregnancy. The process lasts approximately 10 to 12 days, depending on the patient, and during this time, the patient is monitored through ultrasounds to observe follicle growth and to determine when to perform the egg retrieval.

When the follicles have reached adequate growth, another hormone (hCG) is administered to complete egg maturation, and 36 hours later, follicular puncture is scheduled. This minimally invasive procedure is performed under sedation in the operating room and takes about 15 minutes.

Once the eggs are obtained, sperm are introduced using micromanipulation techniques. Special plates with a dense culture medium at the center are used for this procedure, making it difficult for the sperm to “swim.” This way, our specialists select those with the best morphology that swim straighter. For the ICSI technique, two thin pipettes are used: one to hold the egg in place and the other, shaped like a needle, to inject the sperm into the egg. This procedure is performed carefully and with precise, delicate movements. The same process is repeated for each egg retrieved.

Afterward, all fertilized eggs are kept in a state-of-the-art incubator for 2 to 6 days to observe their development and morphological quality, determining the right moment for transfer to the mother’s uterus.

Embryo Culture in the Laboratory

The resulting embryos from the procedure are observed in the lab and classified based on their morphology and division capacity. At WeFIV, we use a non-invasive embryo selection technique that allows us to monitor embryos in culture media with a specific composition tailored to their nutritional needs during their development up to the blastocyst stage.

Scientific studies suggest that pregnancy rates are better when embryo transfer to the uterus occurs during the blastocyst stage. It is preferable to have not only a good number of embryos but also ones with good morphological and kinetic quality, as better quality is thought to lead to a higher likelihood of reaching the blastocyst stage.

Frequently Asked Questions

In Vitro Fertilization (IVF) is a highly complex treatment where fertilization occurs in the laboratory, outside the woman’s body, and then the embryo is transferred to the recipient’s uterus.

IVF with ICSI (Intracytoplasmic Sperm Injection) is a technique performed within the IVF treatment, involving the introduction of sperm into the egg through a puncture using a specialized pipette, facilitating the fertilization process.

The ICSI procedure aims to increase the chances of fertilization and consequently, pregnancy. This technique has high pregnancy success rates, making it one of the most sought-after assisted reproductive treatments.

The main advantage of the ICSI technique is its ability to assist sperm that cannot reach the egg independently, thereby increasing the chances of fertilization. Additionally, it can be used in cases of low sperm quality, previous vasectomy, infectious disease, or immune-related infertility, among others.

Ovarian stimulation is the first step of ICSI treatment, aiming to retrieve a good number of eggs for IVF. This procedure typically lasts approximately 10 to 12 days depending on each patient. 

Then, the follicular puncture is performed and the sperm is introduced into the eggs. The fertilized eggs are then incubated for a period of 2 to 6 days to observe their development and morphological quality.

There is no fixed number of ICSI attempts that can be made. This depends on several factors, including the woman’s health, sperm quality, and response to treatment. At WeFIV, we conduct personalized evaluations to determine the most suitable assisted reproduction treatment for each patient.

After the embryo transfer to the uterus, a follow-up is carried out to verify whether implantation has occurred. If the pregnancy test is positive and the presence of a gestational sac in the uterus is confirmed through ultrasound, IVF with ICSI can be considered successful.