ICSI (Intracytoplasmic Sperm Injection)

ICSI has been widely practised all over the world since 1992. The treatment involves the fertilisation of the eggs outside the body.

ICSI is indicated for the following reasons:

  • Low sperm count, motility or morphology
  • Surgically retrieved sperm
  • Unexpected failed or low fertilisation during IVF treatment
  • Using frozen eggs and/or frozen sperm
  • PGD (Preimplantation Genetic Diagnosis)

You will have two daily injections for 2-3 weeks. One injection is to stop ovulation and the other one is to stimulate the ovaries to collect a number of eggs and generate a number of embryos (fertilised eggs). These injections are self-administered using a very small needle and pen.

Ovarian stimulation is monitored using 3-4 ultrasound scans and blood tests. When the eggs are ready for collection a late-night trigger injection is given to make the eggs reach final maturation.

Egg collection is done through the vagina under ultrasound scan guidance and intravenous sedation. Normally, no pain is experienced during egg collection. You may experience some cramps, feel a little sore and bruised and/or experience a small amount of bleeding from the vagina after the procedure. You will be asked to use either vaginal progesterone pessaries or injections following egg collection.

The male partner will provide semen sample on the day of egg collection to fertilise the eggs. The embryologists will do sperm wash and swim up so the active and normal sperm are separated from the poorer-quality sperm. A senior embryologist will select a single normal and motile sperm and inject the sperm into the egg under a high-powered microscope.

The embryologists will check how many of the collected eggs have been fertilised the day after egg collection. The embryos will be nurtured in the incubator in the embryology laboratory for 2-6 days.

The embryologists will choose the best quality embryo/s to transfer inside the womb. Embryo transfer is a simple procedure that is not different from taking smear. It is done under ultrasound scan guidance and hence you will be asked to have a full bladder. A fine tube (catheter) is then passed through the cervix and one or two embryo/s are passed down the tube into the womb.

You will be asked to do pregnancy test 2 weeks later. If the test is positive, you will continue using the same progesterone supplement until you have completed 12 weeks of pregnancy. You will be booked for ultrasound scan to check the fetal heart beat 2-3 weeks after the positive.