Male infertility may
be due to:
·
A decrease in sperm
count
·
Sperm being blocked
from being released
·
Sperm that do not work
properlyMale infertility can be caused by:
·
Environmental
pollutants
·
Being in high heat for
prolonged periods
·
Birth defects
·
Heavy use of alcohol,
marijuana, or cocaine
·
Too little or too much
hormones
·
Impotence
·
Infection
·
Older age
·
Cancer treatments,
including chemotherapy and radiation
·
Scarring from sexually
transmitted diseases, injury, or surgery>
·
Surgery to prevent
pregnancy (vasectomy), or failure of vasectomy reversal
·
Retrograde ejaculation
·
Smoking
o Diabetes mellitus thyroid disorders, adrenal disease
Hypothalamic-pituitary
factors
o Hyperprolactinemia
o Hypopituitarism
o The presence of anti-thyroid antibodies is associated with an
increased risk of unexplained subfertility with an odds ratio of 1.5 and 95%
confidence interval of 1.1–2.0.
·
Use of certain drugs,
such as cimetidine, spironolactone, and nitrofurantoin
·
Environmental factors
o Toxins such as glues, volatile organic solvents or silicones,
physical agents, chemical dusts, and pesticides. Tobacco smokers are 60% more
likely to be infertile than non-smokers.
o ICSI or Intracytoplasmic sperm Injection is offered to a couple
when the semen sample does not fall within ‘normal’ parameters. This can be due
to:
§ Oligozoospermia – Low number of sperm in the ejaculate
§ Asthenzoospermia – Poor progression or movement of the sperm
§ Teratozoospemia – High numbers of abnormally formed sperm
ICSI Treatment in India with Progeny IVF-ICSI CENTER Delhi
The ICSI
fertility treatment is especially helpful in
reproductive medicine,making fatherhood
possible for men with sperm disorders. If a sperm fails to fertilize the egg
naturally or during IVF, this is usually because the sperm fails to penetrate
the egg’s outer and inner membrane.
Intra Cytoplasmic
Sperm Injection (ICSI) is the injection
of a single sperm directly into the cytoplasm of the egg.
Who requires ICSi
Patient who have low sperm count, very poor
motility or a high percentage.
.
What is ICSI?
·
What is ICSI? ICSI is
an acronym for intracytoplasmic sperm injection
·
ICSI is a very
effective method to fertilize eggs in the IVF lab after they have been
aspirated from the female
·
Its main use is for
significant male infertility cases
·
IVF with ICSI involves
the use of specialized micromanipulation tools and equipment and inverted
microscopes that enable embryologists to select and pick up individual sperm in
a specially designed ICSI needle.
·
The needle is
carefully advanced through the outer shell of the egg and the egg membrane – and the sperm is injected into the inner part
(cytoplasm) of the egg.
·
This usually results in
normal fertilization in about 75-85% of eggs injected with sperm.
·
However, first the
woman must be stimulated with medications and have an egg retrieval procedure so
we can obtain several eggs for in vitro fertilization and ICSI.
Who should be treated with intracytoplasmic sperm injection?
There is no “standard of care” in this field
of medicine regarding which cases should have the ICSI procedure and which
should not. Some clinics use it only for severe male factor infertility, and
some use it on every case. we at progeny ivf icsi clinic are doing ICSI for all
patients undergoing IVF treatment as our embryologist Sudesh Kamat IS THE FIRST
EMBRYOLOGIST TO GIVE FIRST ICSI BABY TO INDIA in 1992 . HE IS DOING 10-30 ICSI
CASES EVERY DAY TRULY SPEAKING HE HAS MAGIC IN HIS HANDS .The large majority of
IVF clinics are somewhere in the middle of these 2 extremes.
Common reasons used for performing ICSI
·
Severe male factor
infertility that do not want donor sperm insemination.
·
Couples with infertility with:
o Sperm concentrations of less than 15-20 million per milliliter
o Low sperm motility – less than 35%
o Very poor sperm morphology (subjective – specific cutoff value is debatable)
o Sperm concentrations of less than 15-20 million per milliliter
o Low sperm motility – less than 35%
o Very poor sperm morphology (subjective – specific cutoff value is debatable)
·
Having previous IVF
with no fertilization – or a low rate of fertilization (low percentage of
mature eggs that were normally fertilized).
·
Sometimes it is used
for couples that have a low yield of eggs at egg retrieval. In this scenario,
ICSI is being used to try to get a higher percentage of eggs fertilized than
with conventional insemination of the eggs (mixing eggs and sperm together).
How is ICSI performed?
·
The mature egg is held
with a specialized holding pipette.
·
A very delicate, sharp
and hollow needle is used to immobilize and pick up a single sperm.
·
This needle is then
carefully inserted through the zona (shell of the egg) and in to the center
(cytoplasm) of the egg.
·
The sperm is injected
in the cytoplasm and the needle is removed.
·
The eggs are checked
the next morning for evidence of normal fertilization.
Fertilization and pregnancy success rates with ICSI
Fertilization rates for ICSI: Most IVF
programs see that about 70-85% of eggs injected using ICSI become fertilized.
We call this the fertilization rate, which is different from the pregnancy
success rate.
Pregnancy success
rates for in vitro fertilization procedures with ICSI have been shown in some
studies to be higher than for IVF without ICSI. This is because in many of the
cases needing ICSI the female is relatively young and fertile (good egg
quantity and quality) as compared to some of the women having IVF for other
reasons.
In other words, the average egg quantity and
quality tends to be better in ICSI cases (male factor cases) because it is less
likely that there is a problem with the eggs – as compared to cases with
unexplained infertility. Some unexplained cases have reduced egg quantity
and/or quality – which lowers the chances for a successful IVF outcome
Sometimes IVF with ICSI is done for “egg
factor” cases – low ovarian reserve situations. This is when there is either a
low number, or low “quality”of eggs (or both). In such cases, ICSI
fertilization and pregnancy success rates tend to be lower.
·
This is because the
main determinant of IVF success is the quality of the embryos.
·
The quality of the
eggs is a crucial factor determining quality and viability of embryos.
In some cases, assisted hatching is done on the embryos prior to transfer, in order to maximize chances for pregnancy
In some cases, assisted hatching is done on the embryos prior to transfer, in order to maximize chances for pregnancy
Looking for Fertility treatment in India, send you medical and
pregnancy history to info@ivfprogeny.com for a free online consultation.
