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ICSI is a specific assisted reproductive technologies (ART) technique of in vitro fertilization (IVF). ICSI involves selecting the most potent, single sperm with the best motility and injecting them directly into a fertile ovum with a micro-needle for assisted fertilization. The embryo is then cultured in a sterile embryology laboratory until it reaches the stage of day-5 embryo (Blastocyst).
The following uterine transfer of the blastocyst allows continuing development in the womb. ICSI is accepted as a safe and highly effective medical technology for men with male-factor infertility, such as unhealthy sperm, low sperm count, and women with low egg counts, thick eggshells, or an unhealthy uterus, to have a successful pregnancy outcome.
The following uterine transfer of the blastocyst allows continuing development in the womb. ICSI is accepted as a safe and highly effective medical technology for men with male-factor infertility, such as unhealthy sperm, low sperm count, and women with low egg counts, thick eggshells, or an unhealthy uterus, to have a successful pregnancy outcome.
Intracytoplasmic Sperm Injection (ICSI)
ICSI Treatment at LaVida: Advanced Technique for Fertility Enhancement
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.
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.
Suitable for who?
1. Male Factor Infertility:
ICSI is primarily used when there are issues with sperm quantity, quality, or motility. This includes men with low sperm count (oligospermia), poor sperm motility (asthenospermia), or abnormal sperm morphology (teratospermia).
2. Previous Failed Fertilization Attempts:
If conventional IVF (In Vitro Fertilization) has failed due to poor fertilization rates, ICSI may be recommended to improve the chances of successful fertilization by directly injecting sperm into the egg.
3. Sperm Retrieval Difficulties:
Men who have difficulty producing sperm (azoospermia) or those who have had sperm retrieved surgically from the testicles or epididymis may benefit from ICSI, as it ensures that the available sperm are directly used for fertilization.
4. Genetic or Chromosomal Abnormalities:
Couples with genetic or chromosomal abnormalities that increase the risk of passing on genetic disorders to offspring may opt for ICSI with preimplantation genetic testing (PGT) to screen embryos before transfer.
5. Unexplained Infertility:
In cases where the cause of infertility remains unclear despite thorough evaluation, ICSI can sometimes offer a higher chance of successful fertilization and pregnancy compared to conventional IVF.
6. Advanced Maternal Age:
Women over the age of 35 may experience decreased egg quality, making fertilization more challenging. ICSI can be used to optimize fertilization rates in such cases.
7. Frozen Eggs:
Eggs that have been previously frozen (cryopreserved) may have harder outer shells, making them difficult to fertilize using conventional IVF. ICSI can overcome this barrier by directly injecting sperm into the egg.
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