ICSI Treatment for Infertility
Treating infertility with assisted reproductive technology (ART) includes removing eggs and sperm for fertilization outside the body. In vitro fertilization (IVF) is probably the best-known ART, where the egg is fertilized by the sperm in a laboratory with hopes of creating embryo(s) that can be transferred back into the uterus.
With the development of technology, another ART is intracytoplasmic sperm injection (ICSI). While the process is almost identical to IVF, there is a difference in how the sperm fertilizes the egg, where the best quality sperm is directly injected into the best quality egg. This significantly increases the chance of a successful pregnancy.
What is ICSI?
ICSI or intracytoplasmic sperm injection is a special procedure under the umbrella of assisted reproductive technology that increases the chance of a successful pregnancy. It involves the use of a machine that assists in fertilization without waiting for sperm to find the egg on its own. With ICSI, the one strongest sperm will be injected directly into the egg. Once the egg is fertilized, becoming an embryo, it will continue to develop in the laboratory. This embryo will continue to grow in a special solution until it becomes a blastocyst, where it will then be transferred back to the uterus to continuing growing in pregnancy.
The ICSI machine is the latest in assisted reproductive technologies and the fertilization rate with ICSI, when compared with IVF, increases by 15%. There are only a few of these machines in Thailand and are very expensive.
Image of the OLYMPUS IX73 Latest Generation ICSI Microscope use in ICSI
What is the difference between ICSI and IVF?
IVF involves selecting an egg and sperm and combining them in a laboratory to create an embryo. The embryo is then transferred into the uterus to hopefully progress into a successful pregnancy. ICSI is an additional step in the IVF process where one egg and just the strongest sperm is selected to be directly injected into the egg using an ICSI microscope. There are few ICSI machines in Thailand. It is a special technique that increases the chances of pregnancy by up to 70%.
Who should consider ICSI?
• Women over the age of 35
• Women with blocked or narrowed fallopian tubes
• Women experiencing abnormal ovulation
• Women with endometriosis
• Women with severe pelvic adhesions
• Women with genetic conditions
• Men with low sperm motility or low sperm count
• People suffering from unexplained infertility
• People with problems with fertilization
The ICSI Procedure (Step-by-step)
The ICSI Procedure
The ICSI procedure is made up of six steps as follows :
Step one: Doctor consultation
The doctor will explain the procedure and preparation and set up the treatment plan. (Please see the doctor before your period.)
Step two: Ovarian stimulation
The doctor will check your hormone levels and carry out an ultrasound to start. You will receive an ovarian stimulation injection on the second or third day of your cycle. The doctor will then schedule ultrasounds and blood tests to monitor the growth of your eggs and check your hormone levels. This process takes approximately 10 days.
Step three: Egg and sperm collection
Once the eggs have reached the desired sizes, the doctor will remove them from the ovaries. The procedure is done under sedation and a needle is inserted through the vagina into the ovaries to collect the eggs. This procedure takes 20-30 minutes. Sperm also needs to be collected and only the best quality sperm are kept to be used in the fertilization process in the laboratory.
Step four: Embryo development
Embryos are kept in the laboratory until they become six- to eight-cell embryos and then on to strong blastocysts.
Step five: Embryo transfer
Once ready, the doctor and patients will select an embryo to be transferred into the uterus. This is done through the vagina and does not require anesthesia.
Step six: Pregnancy test
The doctor will schedule blood tests every three days after embryo transfer to check hormone levels. Pregnancy can be tested for 14 days after the transfer.
How to prepare for ICSI treatment?
- A physical examination to be used for treatment planning; this should be done on the second or third day of your cycle.
- Blood tests to check hormone levels and an ultrasound in the first days of your period to assess if your ovaries are functioning effectively.
- Examination of your uterus either with ultrasound or through hysteroscopy to determine the best method for fertilization.
- Get adequate rest.
- Avoid caffeine.
- Avoid alcohol and cigarettes for at least three months before treatment starts.
- Please let the doctor know if you have any existing medical conditions and please bring all medications you are taking when you see your doctor.
- Avoid ejaculating five to seven days before seeing the doctor.
- Avoid alcohol and cigarettes for at least three months before treatment starts.
- Exercise regularly, but not too much and not too little.
- Avoid tight underwear.
- Avoid soaking in hot water and using the sauna.
- Avoid stress; try to stay relaxed.
- Get adequate rest.
What to do after the embryo transfer?
- After embryo transfer you will need to rest at the clinic for two hours.
- You can resume normal activities as you are comfortable doing so.
- Avoid strenuous exercise.
- Avoid lifting heavy objects.
- Try to eat foods that are gentle on your stomach.
- If you have a fever, you can take fever medication.
- Avoid sexual intercourse and vaginal douching.
- Try to stay relaxed; stress affects your hormones. Looking for ways to stay distracted.
- If you experience any abnormal symptoms, such as abdominal pain, vaginal bleeding, or excessive vaginal discharge, please return to see your doctor immediately.
Pros and Cons of ICSI for Infertility
Pros of ICSI
- It is currently the ART with the highest success rate.
- It can treat a variety of problems.
- No surgery is required.
- It can be done even after a tubal ligation.
- It can be done even with low sperm motility.
- Genetic testing (next-generation sequencing or NGS) of the embryo can be done before it is transferred.
Cons of ICSI
- ICSI costs significantly more than IUI.
- It has a more complicated procedure.
- The procedure lasts many days.
- Some patients may experience side effects from egg collection, such as abdominal discomfort.
What are the success rates for ICSI?
The ICSI success rates by age
ICSI is an additional step in the IVF process where one egg and just the strongest sperm is selected to be directly injected into the egg using an ICSI microscope. There are few ICSI machines in Thailand. It is a special technique that increases the chances of pregnancy by up to 70%.
ICSI fertilization failure reasons
There are usually three main reasons why ICSI doesn’t lead to a pregnancy.
- The endometrium, which is the lining of the uterus, plays an important part in the process as that’s where the embryo must attach. If the endometrium isn’t strong or thick enough, the embryo—as high-quality as it is—cannot implant.
- The quality of the embryo might be another reason that pregnancy hasn’t occurred. Even though the best sperm and eggs are selected and the embryos carefully developed in our state-of-the-art laboratory and cared for by our embryologists, not all embryos are guaranteed to be of good quality or healthy enough to be transferred. Unhealthy embryos that are transferred will unlikely implant and lead to pregnancy.
- Sometimes hormones are to blame. Estrogen is required in large amounts during pregnancy to develop blood vessels between the uterus and placenta, which is responsible for sending nutrients to the fetus. Progesterone also increases in pregnancy to help the body keep the pregnancy. Changes in these hormones allow tendons and joints to relax, preparing the body for pregnancy. But when these hormones aren’t produced and released in the amount needed to sustain pregnancy, the embryo may fail to attach or may attach and stop developing.
How much does ICSI treatment cost?
When compared with intrauterine insemination (IUI), ICSI costs significantly more, but it is a worthwhile investment when dealing with infertility. The starting cost of ICSI is 200,000 baht and can go up to 500,000 baht per cycle, depending on the facility. ICSI is an involved process that is made up of several important steps: ovarian stimulation, preventing ovulation, triggering egg maturation, ultrasounds, egg and sperm collection costs, and the ICSI procedure itself—all of these have their own expenses.
At BeyondIVF we are please to offer a promotion price of 300,000 baht for one cycle of ICSI, which covers almost the entirety of the ICSI process.
Bangkok ICSI / IVF Center
Why choose BeyondIVF for ICSI?
With the rising popularity of assisted reproductive technologies like IVF and ICSI in those over 30 or those experiencing infertility, there are endless options of small and big clinics and hospitals that offer treatment options for infertility. But choosing the right place to help you start your family shouldn’t be solely a financial decision. Consider safety, professionalism, and the skills of specialist doctors—all important components of this journey.
At BeyondIVF, our doctor is a highly trained and experienced fertility expert, with credentials and expertise on top of being a renowned obstetrician and gynecologist who graduated from Ramathibodi University. Furthermore, our clinic prides itself on its high standards for cleanliness and safety. We offer several options to treat infertility, including egg freezing to prevent problems conceiving down the road. Our team is knowledgeable and professional, and we use the best technologies in the world comparative to the big international hospitals.
FAQs about ICSI
How long does the ICSI process take?
In a fresh embryo transfer, where the embryo is transferred immediately after it is ready, the process takes about 15 days. For a frozen embryo transfer, where a stored embryo is used, the process is longer because we must wait for the next menstruation cycle and medications must be taken to prepare the uterus for implantation. Thus, the frozen embryo process takes about one month.
Is the ICSI procedure painful?
Because there are blood tests and IVs involved in the process, some patients may experience discomfort from those. Sedation is used during egg collection as well as anesthesia so there is usually no pain involved. Side effects may include pelvic pressure, mild vaginal bleeding, and/or abdominal discomfort. If you experience any abnormal symptoms, please contact the doctor immediately.
Can ICSI lead to a twin pregnancy?
Thailand does not allow the transfer to multiple embryos and a twin pregnancy is considered high risk. It is not recommended to have more than one fetus during pregnancy. However, in some cases, the doctor my recommend the transfer of two embryos at the same time. This decision is based on many factors, one of which is the quality of the embryos. If the embryos are not of good quality, the doctor may recommend transferring two with the hopes that one might be healthy enough to implant, essentially doubling the chances of pregnancy. If both embryos implant, it could develop into a twin pregnancy. This will then be closely monitored by the doctor.
Can I choose my child’s gender with ICSI?
In Thailand it is illegal to choose your child’s gender, but chromosomal testing of embryos before transfer will reveal an embryo’s gender. Chromosomal testing not only reveals abnormalities or indicates health of the embryo, it also reveals if the embryo has XX (female) chromosomes or XY (male) chromosomes.
However, your doctor will recommend that you choose to transfer the healthiest embryo rather than select by gender, which is, as stated above, illegal.
Is ICSI possible after tubal ligation?
Whether your fallopian tubes are tied or clipped, ICSI or IVF are both possibilities and don’t require the tubal ligation to be reversed. The fallopian tubes are not necessary in these procedures. Furthermore, your chances of success are not affected by tubal ligation.
To learn more about ICSI treatment
ICSI is a special procedure that has been developed from IVF, increasing the chance of a successful pregnancy up to 70%. If you are experiencing any problems conceiving or are dealing with infertility, please see a doctor first for a thorough examination so the right treatment can be designed for your individual case.
For a complimentary consultation to prepare for pregnancy or discuss infertility, please contact us on Line @beyondivf