ABC’s of infertility – ICSI and IVM

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What is Intra-cytoplasmic sperm injection (ICSI)?

Intra-cytoplasmic sperm injection (ICSI) is a method used in IVF which involves selecting a single sperm which is then injected directly to the egg. Therefore it is a great treatment in cases of male infertility when a man has very low sperm count. However not only, it can also be used in cases of other problems with sperm like poor morphology or if the sperm has very slow movement. Furthermore it is an option for men which had vasectomy or extremely low sperm count then the sperm can be surgically collected directly from the testicles. It can also be recommended if in past IVFs fertilization failure occurred.

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Before doing ICSI

Before you are allowed to undergo ICSI you need to have blood tests to screen for HIV, hepatitis B and C, human T cell lymphotropic virus (HTLV) I and II.
For a woman the procedures starts with stimulating the ovaries with drugs so they produce more eggs like in an IVF procedure. The whole progress is monitored by a vaginal ultrasound scans and sometimes blood tests. Next there is the egg collection as same as in the IVF and your eggs are injected with sperm. The rest is again the same as in IVF.

ICSI process

Your partner can provide a fresh semen sample at the day of collection or by doing percutaneous epididymal sperm aspiration (PESA) it involves using a syringe and collecting it directly from the epididymis.It can also be collected by testicular sperm aspiration (TESA), in this process the sperm is retrieved directly from the testicles.
There is also the testicular sperm extraction (TESE) method which involves removing a tiny bit of testicular tissue and extracting sperm from it.
After the sperm is collected a single sperm is injected into each egg. If everything goes all right fertilization occurs. Next the embryos all cultured in the laboratory. After a couple of days, maximally 6 days the best quality embryos are transferred into the womb.

What is In vitro maturation (IVM)?

In vitro maturation is a process of removing the eggs from the ovaries at a time when they are still not mature. Next the proper development to a mature state is done in a laboratory before fertilization. The difference between IVM and IVF is that in the first the eggs are immature at the stage of collection. Which means that the treated woman does not need as many medication before the egg collection.
You may be recommended to do IVM if you are susceptible to ovarian hyper-stimulation syndrome and in cases of the infertility being identified as a male factor infertility.

What thas In vitro maturation involve?

The procedure of IVM involves three steps which are:

  1. Eggs are collected when they are still immature at an earlier stage – this way less medication is needed.
  2. In the laboratory eggs are put in a dish in an incubator where they stay for 1 to 2 days until they are mature.
  3. Finally the eggs are fertilized when they are finally matured using the sperm of your partner or the donor. Next the embryos are cultured and transferred into the womb.

Chances of getting pregnant with IVM or similar to those using IVF. There are few additional risks when undergoing IVM like the fact that there are less eggs to be collected than in a IVF treatment and the general risk of using an aesthetic.