ICSI

What Does ICSI Mean?

meaning of icsi treatment :Some couples are unable to have children after several years of wedding. Today, there are several techniques of assisted reproductive technology such as ICSI. If you have had difficulty in having children, an ICSI cycle can be suggested to your couple depending on your medical records.
Discover the ICSI technique which is among the most effective techniques of ART with Tunisia Medical Travel, during and after your ICSI stay in Tunisia.

Who is a suitable candidate for ICSI?

A suitable candidate for ICSI (Intracytoplasmic Sperm Injection) is typically someone with male factor infertility issues or previous failed fertilization attempts. ICSI is a specialized fertility treatment that involves injecting a single sperm directly into an egg to facilitate fertilization. It is recommended for individuals or couples who face challenges with natural conception due to male infertility problems, such as low sperm count, poor sperm motility, or abnormal sperm shape. Additionally, ICSI may be considered if conventional IVF (In Vitro Fertilization) procedures have not resulted in successful fertilization in the past. By precisely introducing sperm into the egg, ICSI can overcome certain obstacles that hinder fertilization and increase the chances of achieving a successful pregnancy.

What is icsi exam?

ICSI or Intracytoplasmic Sperm Injection is an improved technique of in vitro fertilization (IVF). The steps of an ICSI cycle are identical to those of IVF except for the fertilization technique in the IVF laboratory. Once the ICSI protocol is indicated, the woman will undergo the following steps.

Ovarian Stimulation Phase

Once a fertility evaluation and consultation has been performed, have learned about your ICSI fertility cycle and the decision has been made to undergo the ICSI fertility  procedure, the first step of the process begins: the ovulation stimulation phase. In this crucial phase, the ovaries are stimulated to produce as many follicles as possible – the eggs in the ovaries by hormonal preparations 9 to 12 days a week, starting from the second or third day of the period.

There are hundreds of thousands of follicles in the ovaries, each of which contains an egg (an immature egg). During a normal menstrual cycle, several of these follicles begin to grow and develop, but normally only one follicle produces a mature egg. The goal is for all of the developing follicles to produce a mature egg, which is retrieved for the best chance of success.

In this phase, your physician will monitor the response of your ovaries to the hormonal preparations. During the 9 to 12 day stimulation phase, you will be asked to come to the clinic every few days for blood tests and ultrasound scans. Based on these results, your doctor can adjust your treatment plan and medications. Once test results show that your eggs are fully mature, your doctor will give you a « trigger injection »-a hormone (usually human chorionic gonadotropin, hCG, or leuprolide acetate, Lupron)-to prepare your eggs for ovulation, so that your eggs can separate from the follicle wall and your doctor can perform the egg retrieval.

Egg Retrieval and Semen Collection

36 hours after the trigger point injection, the eggs will be aspirated from the follicles through a small surgical procedure. The surgeon uses ultrasound to pass a fine needle through the pelvic cavity to remove the eggs. The procedure is performed under general anesthesia to make it comfortable and painless. The entire procedure usually takes only 15-20 minutes. On the same day that the eggs are retrieved, your partner’s sperm is also retrieved. Usually, the doctor prefers that your partner’s husband collect fresh sperm at the clinic, but if he is unable to come to the clinic that day, he can take a sperm sample the day before the egg collection and freeze the washed sperm.

It is recommended to collect semen by masturbation to avoid exposure to male or female body fluids (e.g. saliva, vaginal fluids). These fluids may contain bacteria that can contaminate the fertilization or culture medium. After taking the sample, the man hands it through the window to the specialist waiting in the androgen laboratory.The collected semen is left for about 30 minutes to liquefy, after which it is washed to remove debris, non-motile sperm and other substances from the semen, the quality of which is thoroughly analyzed in a procedure called semen analysis. The semen analysis is important because it helps the doctor decide whether to fertilize the eggs with your partner’s sperm using the normal IVF method or the advanced ICSI method. But if the semen analysis results are lower than average, your physician may advise you to choose the second alternative fertilization ICSI technique, as it increases the chance of that fertilization will occur.

ICSI Fertilization

If you and your doctor agree that ICSI is the best method of fertilization, the embryologist will use a small pipette to select a normal-shaped, fast-moving sperm and inject this healthy sperm directly into the selected mature egg, rather than letting the egg and sperm fertilize each other in a laboratory dish as in conventional IVF. The next morning, the embryologist checks for signs of normal fertilization. All normally fertilized eggs are called embryos.

Embryo Culture

Once the egg and sperm have been fertilized and become embryos, they grow in a special incubator for 5-6 days until they develop and grow to the blastocyst stage, which to be implanted in the uterine lining. Embryos that do not reach the blastocyst stage are not considered healthy enough to be implanted in the uterus.

 Embryo Transfer

Finally, the physician and embryologist choose one or more blastocysts to be transferred into the uterus to develop into a child. In this process, an experienced embryologist inserts the selected blastocyst into a small tube, called a catheter, under ultrasound guidance. The physician guides the blastocyst into the uterus through the cervix and releases it into the wall of the uterine cavity (endometrium), where it can implant in the uterine wall and develop and grow. Seven to 10 days after the embryo transfer, you may have a blood test to see if you are pregnant. To confirm your pregnancy, you may have an ultrasound in about two weeks.

IVF or ICSI: IVF or ICSI which is better?

After ovarian stimulation, egg and sperm collection, the oocytes are placed in a culture medium for fertilization. The carefully selected sperm is placed directly into the oocyte, which is not the case with conventional IVF, where the sperm is released into the culture medium with the oocytes and the selection is made in a natural way. The chances with an ICSI cycle are increased thanks to a prior selection of spermatozoa and by forcing penetration of the latter in the oocyte. Several studies have shown that ICSI has better results than conventional IVF. The embryo transfer is also done 2 to 5 days after the oocyte puncture.

ICSI treatment cost

Depending on the IVF diagnosis and the case, an ICSI is suggested from 1500 Eur. To receive a personalized quotation with a cheap ICSI  cost, please contact us. Tunisia Medical Travel can also offer you other services such accommodation, various transfers etc. Do not hesitate to contact us to request a quote in USD or in Eur.

ICSI procedure: what do you need to know before you start

ICSI requires a good preparation of the couple. The fertility specialist will carefully study your medical file to identify the causes of infertility. Investigations will also be requested before starting an ICSI cycle in Tunisia. Once ICSI has been confirmed, Tunisia Medical Travel can assist you in organizing your ICSI medical trip in Tunisia.

How does ICSI work ?

You should plan a stay of about three weeks in Tunisia. Depending on the country of origin, some couples shorten their stay by one week if they decide to start the ovarian stimulation at home. Egg collection and embryo transfer as well as fertilization will be done at the largest IVF center in Africa.
Most couples choose to stay in a furnished flat next to IVF center or the specialist’s office for convenience and budget reasons.

ICSI :Post-procedure ICSI

During the entire ICSI cycle, several visits are to be expected at the IVF center and at the specialist cabinet. The post-procedure period requires almost no convalescence since all steps are done on an outpatient basis and are not incisive.

Pros and cons of icsi

ICSI, or intracytoplasmic sperm injection, is a form of IVF (in vitro fertilization) that is most often used in cases of extreme male infertility, after egg storage (egg freezing) or in cases of repeated failed attempts at conventional IVF. In conventional IVF, several sperm are collected along with one egg. This is done to allow the sperm to penetrate the egg and fertilize it naturally. In contrast, in the ICSI procedure, an embryologist takes one sperm and injects it directly into the egg.

In some fertility clinics, ICSI is recommended for all IVF cycles, but in others it is only used in extreme cases of male infertility and for certain medical reasons. Although it is a very advanced method, ICSI has some disadvantages, mainly related to risk factors. These disadvantages discourage routine use of the treatment.

ICSI Result

If the woman gets pregnant at the end of the ICSI cycle, it is essential to ensure a good follow-up by her gynecologist back home. The team of Tunisia Medical Travel will remain at your disposal even after your departure.

Are there any risks or complications associated with ICSI?

ICSI (Intracytoplasmic Sperm Injection) is generally a safe and effective fertility treatment, but like any medical procedure, it does come with some risks and potential complications.

It’s essential for individuals or couples considering ICSI to be aware of these factors :

• Ovarian Hyperstimulation Syndrome (OHSS) : One of the risks associated with ICSI is the possibility of OHSS, which can occur when the ovaries respond excessively to the fertility medications used to stimulate egg production. This condition can lead to abdominal discomfort, bloating, and in severe cases, fluid accumulation in the abdomen and chest. However, with proper monitoring and medical care, the risk of OHSS can be minimized;
• Multiple pregnancies : ICSI can result in the development of multiple embryos, and if more than one embryo is transferred to the uterus during the procedure, there is a higher chance of having a multiple pregnancy (twins, triplets, etc.). Multiple pregnancies carry an increased risk of complications for both the mother and the babies;
• Fertilization failure : Although ICSI is designed to facilitate fertilization, there is still a possibility of fertilization failure. Not all eggs may successfully fertilize, leading to a lower number of embryos available for transfer or freezing;
• Birth defects : Some studies have suggested a slightly higher risk of certain birth defects in babies conceived through assisted reproductive technologies like ICSI. However, it is essential to note that the overall risk of birth defects is still relatively low and comparable to natural conception;

What should I choose? IAC, IVF, ICSI?

After studying the couple’s fertility file, the specialist will suggest an intrauterine insemination (IUI), an in vitro fertilization (IVF) or an ICSI. ICSI is given in the first place to couples having gad several attempts of IVF or IUI and if the age of the woman is relatively advanced.

Contact and quote request for IVF

Tunisia Medical Travel will assist you in preparing your IVF file and organizing your medical stay. Do not hesitate to contact us for more information.