INTRACYTOPLASMIC SPERM INJECTION (ICSI)

1. Initial Steps
Please arrive Bangkok immediately around day 2-3 of menstrual period.

2. First Examination and Consultation with the Physician
Travel to Bangkok the night before seeing the doctor. Visit the doctor in the morning according to the appointment time for initial examinations conducted by nurses, such as weight measurement, blood pressure measurement, and asking about medical history. At the same time, provide basic information about the vitrification process and answer patient questions.

Doctor’s Examination Structure:
– Ultrasound Examination – Perform ultrasound to assess the uterus and the size of egg follicles on both sides.
– Blood Test – Draw blood to measure hormone levels like FSH , LH and E2 . Additionally, tests for various infections such as AIDS, hepatitis B, and hepatitis C are conducted.
– AMH, TSH, Free T3,Free T4, The doctor reviews each test result to calculate the appropriate dosage of egg-stimulating medication for the patient.

After completing the examination with the doctor, a nurse will instruct on injecting egg-stimulating medication. The patient will then need to inject medication in the abdominal area (fat layer) continuously for 8-12 days. Injections should be done at the same time each day, with no more than a 1 hour difference. Once the patient becomes proficient in self-injection, they can administer the injections themselves.

3.Second Examination
Starting from the first day of egg-stimulating medication until day 5, the patient must return for a blood test and ultrasound examination to assess the size of the egg follicles and the thickness of the uterine wall. Based on these examination results, the doctor may adjust the dosage of egg-stimulating medication if necessary to ensure continuous and effective treatment. If the egg reaches a size of 13 millimeters or more, and LH hormone starts rising, medication to prevent premature egg release may be administered.

4.Third/Fourth Examination and Follow-up Treatment
Starting from day 8 of egg-stimulating medication, the patient must return for hormone tests and ultrasound examinations. If the egg reaches a size of 17 millimeters, the doctor may schedule a “Trigger shot” to induce egg release at a specified time. Meanwhile, the male partner must arrive in Bangkok before the egg retrieval procedure to prepare for sperm collection.

5. Egg Retrieval and Sperm Collection
After 36 hours after the Trigger shot, eggs are retrieved. Before the procedure, the patient must fast from food and water for 8 hours.

Egg retrieval is performed under sedation (anesthesia). Using a needle, the doctor retrieves eggs from the ovaries guided by ultrasound through the vaginal canal. After egg retrieval, the patient should rest and care for their body for approximately 1-2 hours at the hospital.

On the same day, the male partner collects sperm by masturbation. Before sperm collection, the male partner should abstain from ejaculation for at least 2-3 days but not more than 7 days.
If sperm collection on the same day is not feasible, freezing sperm is an alternative option.
Both eggs and sperm collected are then brought to the laboratory for further procedures.

Outcome of Fertilization
One day after egg retrieval, the patient is informed of the fertilization outcome.

6. Embryo Transfer
Frozen embryo transfer (FET) is a process that involves thawing embryos that were previously frozen and then transferring them into the uterus of a woman.

After IVF, any viable embryos that are not transferred immediately can be cryopreserved (frozen) for future use. This allows patients to potentially have multiple attempts at pregnancy without needing to undergo another round of egg retrieval.

Once the embryos are thawed and the uterine lining is prepared, one or more embryos are transferred into the uterus using a thin catheter. This is usually a simple procedure that does not require anesthesia.

Post-Transfer: After the transfer, the woman may be advised to rest for a short period and will typically undergo a pregnancy test about one to two weeks later to determine if implantation has occurred.

Success Rates: Success rates for FET can vary depending on several factors, including the age of the woman, the quality of the embryos, and the overall health of the individuals involved.