A modern method of assisted reproduction, called intracytoplasmic sperm injection (ICSI) was first implemented in 1995 in Austria and since then has helped thousands of couples, struggling with male infertility, to become parents. ICSI involves a special micromanipulation of reproductive material (sperms and eggs) in order to achieve healthy pregnancy. More and more international patients come to Germany for advanced ICSI treatment, which is quite understandable, since Germany is a front-runner in assisted reproduction techniques and can boast higher success rates (pregnancy rates) than the USA or Great Britain. According to statistic data ICSI in Germany helps to increase the efficiency of in-vitro fertilization by 35%.
Intracytoplasmic sperm injection or ICSI can be considered as counterpart of IVF. As in case of IVF, a woman will have to take special stimulation drugs for efficient ovulation. The egg retrieval is performed on the 15th/17th day of a cycle. The oocytes for ICSI obtained during the follicle puncture are placed into special solution and then examined by an embryology specialist. Special digital tools help to examine cells with maximum precision and to define the most vital ones. On the same day a single well-examined sperm is injected into the egg with a special microscopic device (intracytoplasmic fertilization, ICSI). In case the fertilization takes place, the potential embryo is located into embryoscope and cultivated there during the next 4-5 days. The cost of IVF with ICSI makes up about 7 000- 8000 euro.
The procedure is indicated in following cases:
- Reduced sperm motility rate in semen (male infertility)
- Reduced rate of vital sperms in a male patient
- morphological pathology of sperm
- antibodies in semen (MAR-tеst: more than 50%)
- small rate of oocytes (fewer than four) could be obtained after ovarian stimulation
ICSI is also recommended as a complimentary method in case of two or more failed IVF cycles. It helps to achieve pregnancy in complex and even incurable forms of male infertility - for example, in case of azoospermia (no vital sperm in ejaculate) or retrograde ejaculation.
Male sperm is considered capable of fertilization, if one milliliter contains not less than 20 million sperm. More than a third amount of sperm should be mobile and have good morphology. If sperm characteristics deviate from the norm, it may be impossible to achieve pregnancy in a natural way.
The IVF alone may prove to be ineffective in case of poor semen quality, since sperm may be too weak and slow to penetrate an egg shell. The direct injection of male sperm into the egg is able to dramatically increase the chances of pregnancy, making such factors as motility and morphology of sperm almost irrelevant for the therapeutic result. A single motile sperm is enough to perform ICSI fertilization. To compare, 80 000 to 120 000 motile sperm cells are needed for natural fertilization.
Azoospermia is a condition of male infertility, when no motile sperm can be detected in ejaculate. It occurs in 20% of infertile men. In some cases poor semen analysis is caused with obstruction of the ejaculatory tract, which can be eliminated through a minimally invasive surgical intervention. But most frequently no vital sperm in ejaculate is a sign of chromosomal disorders, hormonal problems or other physiological pathologies. All these sperm disorders are considered to be direct indications for intracytoplasmic injection (ICSI).
If there is no vital sperm in the semen, it is possible to obtain vital cells directly from the testicles (TESE, testicular sperm extraction) or from epididymis (MESA, microsurgical epididymal sperm aspiration for ICSI).The decision about testicle biopsy (sperm retrieval with special tools) and ICSI may be taken only after a detailed consultation with the specialist team and after the results of a special survey - SM-ICSI rate.
The major commitment of German fertility centers is your future child, which means than no compromise on quality of medical service can occur during the IVF and ICSI. To learn more about ICSI, IVF and pregnancy rates in Germany, please, call us or fill in a contact form on our web-site.