Intracytoplasmic Sperm Injection (ICSI)

Who Needs Intracytoplasmic Sperm Injection (ICSI)?

Doctors usually recommend ICSI for couples facing:

• Severe male infertility (low sperm count or poor sperm movement)
• Sperm that can’t fertilize eggs naturally
• Previous failed IVF attempts
• Blockages in the male reproductive tract
• Use of frozen sperm or eggs
• Use of donor eggs or sperm

Types of Intracytoplasmic Sperm Injection (ICSI) Procedures

Though the main goal remains the same, that is, injecting sperm into the egg, there are slight variations. These depend on the types of ICSI procedures, including:

• Conventional ICSI: This is the standard method where sperm is injected using a fine needle.
• Assisted Hatching with ICSI: Doctors make a small hole in the outer shell of the embryo to help it implant better.
• PICSI (Physiological ICSI): Doctors select the best sperm using natural binding techniques before injection.

Evaluation and Diagnostics Before Intracytoplasmic Sperm Injection (ICSI) Procedure

Before starting ICSI, both partners have to go through medical evaluations:

• For women: Blood tests, ultrasound, and hormone level checks
• For men: Semen analysis to examine sperm count, shape, and mobility

Doctors may also run genetic tests or screen for infections to ensure safety.

Intracytoplasmic Sperm Injection (ICSI) Procedure Planning

After the evaluation, the fertility expert will create a personalized treatment plan. They select:

• the best time in the menstrual cycle to collect eggs.
• the stimulation protocol for the woman’s ovaries.
• the ideal method to collect and process sperm.

All steps are scheduled carefully to increase the chances of success.

Intracytoplasmic Sperm Injection (ICSI) Procedure

From the initial assessment of the couple’s infertility issues to the implantation of the fertilised egg into the woman’s uterus, the ICSI procedure involves the following steps:

1. Initial consultation: The couple consults a fertility expert to discuss their infertility issues. The specialist determines whether ICSI is suitable for them or not.
2. Ovarian or ICSI stimulation: The woman takes follicle-stimulating hormone (FSH) injections for 10 to 12 days to produce multiple eggs.
3. Egg retrieval: Doctors collect the eggs from the female partner using a thin needle guided by ultrasound or via a minimally invasive procedure, typically under local anesthesia.
4. Sperm collection: The male partner gives a semen sample or undergoes sperm extraction.
5. Sperm preparation: The sperm is prepared for injection by washing and selecting the most viable sperm cells.
6. Sperm injection: A skilled embryologist injects a single sperm (a healthy and viable one) directly into each mature egg under a microscope.
7. Embryo culture or Fertilisation: The fertilized eggs are observed in the lab for 3 to 5 days for signs of successful fertilisation and cell division.
8. Embryo transfer: Typically, 3 to 5 days after fertilisation, the doctor places one or more embryos into the woman’s uterus using a small catheter.
9. Pregnancy testing: Two weeks after the embryo transfer, the female takes a pregnancy test to determine the success of the ICSI procedure.

Risks and Potential Complications of Intracytoplasmic Sperm Injection (ICSI)

ICSI is generally safe, but it does carry some risks. Although these risks are generally low, your fertility specialist will make you aware of them. Here are some of the potential risks:

• Ovarian Hyperstimulation Syndrome (OHSS) from fertility drugs: In rare cases, ovarian stimulation can lead to a serious condition in which the ovaries swell and become painful. The symptoms of OHSS include bloating, abdominal pain, shortness of breath, etc.
• Multiple Pregnancies (Twins or Triplets): Multiple pregnancies can increase the risk of complications during pregnancy and childbirth. They can also increase the risk of premature delivery.
• Failed Fertilisation: There are chances that the eggs do not fertilise with the sperm, or if they fertilise, then the resulting embryos may not develop properly.
• Bleeding and Infection: There is a small risk of bleeding or infection at the site of the egg retrieval procedure.
• Birth Defects: There is a slightly increased risk of genetic issues, especially if the male partner has certain conditions.
• Psychological and Emotional Risks: The process of undergoing fertility treatments can be emotionally challenging for the couple and may result in anxiety, depression, and stress.

The risks associated with ICSI can be easily minimised by working closely with an expert fertility specialist and following all recommended guidelines and precautions.

What to Expect After Intracytoplasmic Sperm Injection (ICSI)?

After the embryo transfer:

• The woman rests for a short period at the clinic.
• She continues taking hormone medications to support the pregnancy.
• A blood test is done after about two weeks to confirm pregnancy.

Post-ICSI Recovery and Long-Term Care

Since ICSI is not a major procedure, recovery after ICSI is usually quick. It includes:

• Women can return to normal activities the next day.
• Mild cramps, spotting, or bloating may occur.
• Emotional support and regular follow-ups help improve the overall experience.

Keep an eye on what you eat and drink. Quit smoking and alcohol intake.

Intracytoplasmic Sperm Injection (ICSI) Success Rate in India

The success rate of ICSI in India varies based on:

• The woman’s age
• Egg and sperm quality
• Lifestyle and health conditions

On average, the success rate ranges between 40% to 60% per cycle for women under 35. It may be lower for older women.

Cost of Intracytoplasmic Sperm Injection (ICSI) in India

India offers affordable ICSI treatment without compromising quality. The average cost of ICSI in India ranges from USD 4,000 to USD 8,000. This may include medication, tests, embryo transfer, and follow-ups. Costs vary depending on the clinic, city, and extra services like embryo freezing or donor sperm.

Why Choose India for Intracytoplasmic Sperm Injection (ICSI)?

India is a top destination for fertility treatments because:

• The fertility hospitals and centres in India comprise experienced ICSI specialists, some of whom are internationally trained and recognized.
• The ICSI procedure is cost-effective in India. The cost is much more affordable in India compared to other Western nations.
• The fertility clinics in India use advanced technologies and maintain international standards.
• Indian hospitals have English-speaking doctors and staff to ensure smooth communication.
• Medical tourism facilitators, such as EdhaCare, provide end-to-end support to international patients.

Documents Required for Patients Traveling to India for Intracytoplasmic Sperm Injection (ICSI) 

For international patients contemplating ICSI in India, it is necessary to present certain documentation to have a smooth medical journey. These include:

• Valid Passport: Valid for a minimum of six months after the date you travel.
• Medical Visa (M Visa): Granted by the Indian Embassy/Consulate on medical grounds.
• Invitation Letter from Indian Hospital: A formal letter explaining the course of treatment and how long it will last.
• Recent Medical Records: X-rays, MRIs, blood tests, and a referral note by a doctor in the home country.
• Completed Visa Application Form: With passport-size photographs according to specifications.
• Proof of Means: Bank statements dated in the past few months or health insurance.
• Medical Attendant Visa: Needed for a companion or caregiver traveling with the patient.

It is advisable to refer to the Indian consulate or your medical facilitator for the latest information and help in documentation.

NOTE: Single parents and same-sex couples should confirm legal requirements with the clinic before starting.

Top Intracytoplasmic Sperm Injection (ICSI) Specialists in India

Some of the top ICSI specialists in India include:

• Dr. Firuza Parikh - Jaslok-FertilTree IVF Centre, Mumbai
• Dr. Bindu Garg - Neelkanth Hospital, Gurgaon
• Dr. Indira Hinduja - P.D. Hinduja National Hospital, Mumbai
• Dr. Durvasula Ratna - Rainbow Children's Hospital, Banjara Hills, Hyderabad
• Dr. Sreeja Rani V R - Kinder Multispeciality Hospital, Bangalore

These experts have decades of experience and high success rates.

Best Hospitals for Intracytoplasmic Sperm Injection (ICSI) in India

Some of the best hospitals and fertility clinics in India for ICSI are:

• Nova IVF Fertility (Multiple Locations in India)
• Max Healthcare, Delhi
• Cloudnine Fertility (Multiple Locations in India)
• Manipal Hospital, Bangalore
• Indira IVF (Multiple Locations in India)

These centers offer comprehensive care, modern labs, and experienced staff.

Frequently Asked Questions (FAQs)

Is ICSI painful?

No, the procedure is not painful. Egg retrieval is done under anesthesia.

Can ICSI help if my partner has zero sperm?

Yes, doctors can extract sperm directly from the testicles using minor surgery.

How long does the ICSI process take?

The entire process usually takes about 4 to 6 weeks.

Is ICSI better than IVF?

ICSI is more effective in cases of male infertility. IVF is suitable when sperm quality is normal.

Can ICSI guarantee pregnancy?

No treatment can guarantee pregnancy, but ICSI offers high success rates, especially with younger women.