In couples where there is severe male infertilityand is unable to conceive even after repeated fertilization attempts by conventional IVF treatment or after egg freezing (oocyte preservation), is the next step in fertility treatment.
If a man does not have any sperm in his ejaculate, but he is producing sperm in his testis, these produced sperms are retrieved through a surgical step called as testicular sperm extraction (TESE).
ICSIis also the method of choice in cases of retrograde ejaculation, where the sperm retrieval is from the urine.
In such cases during the next IVF cycle, ICSI is tried.• Frozen sperm is being used: If the thawed sperm appear to be inactive, ICSI-IVF is on a recommendation.• Frozen oocytes are being used: Verification of eggs can cause hardening of eggshell, which causes complication in fertilization.
IVF with ICSI can help in overcoming this hurdle.• PGD is being done: PGD (Preimplantation Genetic Diagnosis) is an IVF technique which allows genetic screening of embryos.
Who can opt for ICSI?• Couples who want to include PGT in their cycles to ensure fertilization is better.• Couples who are facing severe male infertility• When the only course of action is by sperm retrieval through TESE/MESA• Poor oocyte quality/ low oocyte yield• Suitable for women aged over 40 years of age ( to overcome sperm-Oocyte Penetration Issues)• Couples who are facing repeated fertilization failure• Ejaculatory Dysfunction The procedure involved in IVF-ICSI: As with regular IVF procedure, ovarian stimulation drugs are given.