ICSI

Intracytoplasmic sperm injection (ICSI) is a well-known fertility treatment and an effective form of Assisted Reproductive Technology (ART). It is widely used to treat delays in pregnancy and causes of infertility in both men and women. Most of our infertility cases at Bedaya hospital that are treated with ICSI have high success rates resulting in a healthy pregnancy.

 What is ICSI procedure?

The process of fertilization is complicated; it is more than an egg and a sperm merging. The head of the sperm must attach to the outer layer of the egg, while the rest of the sperm (body) pushes through the cytoplasm (inside layer), this is the point of fertilization.

In some cases, the outer layer of the egg can be thick which makes it hard for the sperm to penetrate, the sperm can have weak or no motility and is therefore unable to swim and breech the outside layer of the egg. In these situations, we must consider undergoing an ICSI procedure as treatment. The process of ICSI includes injecting one single sperm directly into the cytoplasm of the egg by a precise needle, called a micropipette. Once the egg is fertilized and turned into an embryo, the doctors lets it grows in a laboratory dish inside a special incubator for 1-5 days before transferring it back to the patient's uterus.
 

ICSI treatment steps

• Ovarian stimulation: This step of the procedure requires the female partner to take fertility medication 10-14 days prior to the actual ICSI to stimulate her ovaries to produce multiple eggs and then have them mature. During this stimulation period the female partner will be frequently monitored by ultrasound sonography and hormonal levels in blood. When the time is set for the egg pick up the specialist will then use an ultra-sound guided catheter entered vaginally to retrieve the eggs from the female’s ovaries.
• the embryologist will fertilize each egg with one single good quality sperm under the microscope. The fertilized eggs are then incubated under very precise conditions in the embryology laboratory so they can develop.
• If fertilization successfully occured, the embryos will be cultured in a petridish in the laboratory incubator for up to six days and approximately between one to three of the best-quality embryos will be selected for transfer to the female’s uterus.
• All remaining, good quality embryos that are not transferred will be frozen and stored. These frozen embryos can in the future be used by the couple Bedaya Hospital has a very high pregnancy rate for frozen Embryo Transfers (ET). The advantage of freezing good quality embryos after an ICSI cycle is that it offers a very high chance of women getting pregnant in a subsequent cycle without having to go through the whole stimulation and pickup procedure again.

ICSI at Bedaya Hospital

Bedaya Hospital is famed for its successful Assisted Reproduction Technology (ART) and has high ICSI success rates that are equal to international success percentages. From the moment you walk into our hospital to go through the journey of ART including ICSI, you will be taken care of by each member of our staff. Before undergoing ICSI or any other procedure, take your time to do your research and know all about risks, possibilities, costs and success rates. It is your right to know and ask about all details.

• Bedaya Hospital’s infertility clinics have a team of professionals led by professors with over twenty years of experience in this field They are dedicated to their work, and provide you with correct diagnoses and treatment plans.
• The Intracytoplasmic sperm injection (ICSI procedure ) takes place in the embryology laboratory. Starting with the cytoplasm of the egg being injected by a healthy sperm. These fertilized eggs are put in incubators equipped with the latest technology.
• To ensure high fertilization rates several techniques can be used, Assisted Hatching, IMSI technology and sperm amplification.
• Our Hospital is equipped with high-tech equipment and laboratories to give our patients very accurate diagnoses.
• Bedaya Hospital cooperates with fertility research centers and institutes to expand our medical staff’s knowledge and stay up to date in the world of fertility treatments.

Assisted Hatching and ICSI

Failure of embryo implantation in the uterine lining after transfer is one of the most common obstacles we face during IVF and ICSI procedures. Failure of implantation is a negative pregnancy test after transferring good quality embryos due to the incapability of embryos to implant in the endometrium lining. The reasons for implantation failure are unknown. For this group of patients, a technology has been developed to assist the embryos with implantation, the outer layer of the embryo is hatched (the zona pellucida) by laser; this technique is called assisted hatching.

The zona pellucida is an outer layer surrounding the oocytes (eggs) during maturation, ovulation and in the early embryo stages. The zona pellucida works as a mechanical barrier that prevents the dissolution of the egg due to external factors like toxic materials or the immune system , protects the fertilized egg and embryo in its early development stages, and plays a role in the interaction of the ovulated egg and sperm. Modern techniques of in vitro fertilization (outside the female body) shed a light on the functions of the zona pellucida.

In the early nineties research showed that by creating a small hole in the zona pellucida (outer layer) of the embryo in the early development stages increased the possibilities of implantation. In theory this should make an embryo weak or could cause damage compromising its viability however this showed not to be true if done by a skillful embryologist. Research also showed that the zona pellucida is more flexible in an embryo than in an oocyte so it is better to make this small hole in the embryo stage not in the mature oocyte stage this would increase the chances of actually damaging the oocyte by 4% Bedaya Hospital’s embryologists have the expertise to perform assisted hatching without causing negative effects to the embryos.

ICSI success rate and risks

ICSI success rates are high. In some cases, you can guarantee an 80% success rate.

Sometimes, the eggs collected from the ovaries can be damaged or might not develop well after the cytoplasm injection which cause ICSI failure, if this happens, we try different approaches of injection until we succeed in fertilizing the oocytes (eggs).

At Bedaya Hospital, with the expertise we gathered in over 20 years and our top of the notch laboratory equipment we have mastered several techniques that proved successful and made our success rates substantially higher than any other center for fertility treatments in the Middle East.

Can the ICSI procedure affect a baby’s health and growth?

Patients who have done ICSI at Bedaya with positive results have gone on to have normal pregnancies and delivered healthy babies. Research has showed that the rates of abnormalities in the fetus or birth defects of children conceived by Assisted Reproduction Techniques (ART) are equal to those present in natural pregnancies. Birth defects in babies delivered after an ICSI procedure do not exceed 1% and are equal to the percentage of birth defects in babies conceived normally.

Who should have ICSI treatment?

ICSI is very effective in treating the following cases of male infertility:

• Weak motility (sperm movement) and low sperm count
• Problems with Sperm morphology (abnormal form of sperms)
• Diseases that prevent sperms from reaching the oocytes. Ejaculation issues or situations that require extracting sperm cells surgically from the testicles.
• General male infertility problems.
• Fertilization problems (The sperm may have trouble entering the cytoplasm of the egg)

Women with the following conditions should consider ICSI in cases of infertility due to a female factor;

• Women with PCOS
• Women who suffers from blocked Fallopian tubes
• Women who have unexplained infertility.
• Women who had IUI or IVF and were not successful.
• Women who got their eggs frozen.
• Women who are over 40 years old and having trouble in getting pregnant at such age.

What is the difference between ICSI and IVF?

Intracytoplasmic Sperm Injection ICSI and In Vitro Fertilization IVF have proven to be two of the most effective methods of Assisted Reproduction Techniques (ART). The key difference between them is how the egg is being fertilized by the sperm. The IVF process includes extracting multiple eggs and sperms these two are put together and given the chance to fertilize on their own. However, in an ICSI procedure after multiple egg extraction, each egg is put under the microscope and with a microneedle injected by one single good quality sperm. ICSI as a matter of speaking tries to force fertilization.

Which is better for you?

ICSI is mostly recommended for patients with a male infertility factor like abnormal sperm morphology or a low sperm count. ICSI will be very effective and guarantees higher fertilizations rates given the fact that it helps the sperms individually fertilizing the eggs. Your treating doctor will look at your case determine the factors playing a role in your delayed pregnancy and decide which is better for your case.

IVF is commonly recommended if the infertility issue is due to a female factor and she is under the age of 37.