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ICSI (intra-cytoplasmic sperm injection)

What is ICSI treatment (intra-cytoplasmic sperm injection) and How does it work?

ICSI treatment (microfertilization) is one of the extracorporeal insemination techniques, which is used in the case of male infertility in severe form (lack of spermatozoa, abnormalities or low motility of sperm). For the successful performance of the ICSI treatment procedure (spermatozoon injection into the egg cell), only a few of the living, morphologically normal spermatozoon are required.

ICSI treatment – Legal aspect

According to the Latvian legislation, the ICSI treatment procedure may be performed for heterosexual couples, as well as single women under the age of 49, using either the partner's sperm, or sperm from donor.

ICSI treatment procedure step by step

  1. Initial consultation with infertility specialist to collect medical history and determine possible causes of infertility
  2. Consultation of the reproductive specialist + transvaginal ultrasonography (to determine the structure of the uterus and ovaries, anatomical features of the patient, etc.) + blood and urine tests, smears necessary for the ICSI procedure + necessary medications
  3. Necessary procedures before ICSI:
    • Hydrosalpingoscopy (a method of examination that helps to determine the size and shape of the uterine cavity, possible changes and features, as well as the patency of the fallopian tubes) or
    • Hysteroscopy (examination of the uterine cavity through the cervix using a hysteroscope, tiny telescope with light and camera at the end)
    • Blood tests: FSH, estradiol level, etc.
    • Semen analysis (evaluation of structure, concentration, sperm motility), functional sperm analysis
    • All the necessary blood tests (thyroid hormones, prolactin, blood group and Rh factor; tests for infectious diseases (chlamydia, syphilis, HIV, etc.)
  4. Waiting for the start of natural menstruation, the injection of gonadotropic hormones (eg, Gonal F) on average 10 days
  5. Ultrasound check 3 times during the stimulation
  6. When the follicles reach 18-20 mm in size, injections of Pregnyl or Ovitrelle will be prescribed for ovulation induction, and the egg cell collection (ICSI procedure) day will be appointed
  7. ICSI procedure is usually done on the 12th day from the start of stimulation

    How does ICSI treatment work?

    Egg (oocytes) collection – requires short-term intravenous anesthesia*
    Sperm delivery and its subsequent preparation for ICSI manipulation in the laboratory conditions. The collected eggs are placed in a special medium, and then the sperm is injected directly into the cytoplasm of the egg*

    *These procedures take approximately 4 hours
  8. Cultivation of embryos up to 3 - 5 days
  9. Transfer of the embryo into the uterus
  10.  Supportive drug therapy for at least 14 days
  11.  Checking of HCG and progesterone level on the 14th day after the embryo transfer
  12.  Ultrasound examination to confirm pregnancy 4 weeks after the embryo transfer

Depending on the results of the tests and ultrasound, the reproductive specialist determines whether to continue using drugs.