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In Vitro Fertilization also known as IVF, was first performed in 1978, and has become the standard for treating many fertility disorders. At Saint Mary Fertility Center IVF has helped many happy couples start families, as reflected in our IVF success rates. IVF treatment is a multi-step process involving ovulation induction, follicular aspiration, insemination and embryo transfer. Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during one of the woman's cycles. This is often referred to as ovulation induction. The eggs are retrieved during a minor surgical procedure, using ultrasound imaging to guide a hollow needle(called follicular aspiration) through the pelvic cavity, under a mild general anaesthesia.
the sperm, usually obtained by ejaculation, is prepared for a process called insemination, in which the sperm and the eggs are placed together in incubators in the laboratory enabling fertilization. Once this occurs, the fertilized eggs are considered embryos.
The embryos are usually transferred into the woman's uterus anywhere from one to six days later, but most commonly between two to three days following egg retrieval. in this simple and painless procedurem the embryo(s) is/are transferred into the uterus using a thin catheter, without the need for sedation os anaesthesia.
these steps are followed by rest and watching for early pregnancy symptoms. A blood test, and potentially and ultrasound, will be used to determine if implantation and pregnancy has occured.
What is Intra-Cytoplasmic Sperm Injection (ICSI)?
Intra-Cytoplasmic Sperm Injection (ICSI) would be performed instead of regular In Vitro Fertilization (IVF) this method involves injecting a single sperm directly into an egg in order to fertilise it. With ICSI, the eggs are retrieved the same as if you were doing conventional IVF. However, the eggs and the sperm are then fertilized in the laboratory, by direct injection of a single sperm into each egg. Three days later the resulting embryos are simply placed into your uterus with no surgery, just as with IVF. extra embryos are frozen for later attempts at pregnancy.
The major development of ICSI means that as long as some sperm can be obtained (even in very low numbers), fertilisation is possible. The availability of this Intra-Cytoplasmic Sperm Injection, "ICSI" technique means that men whose sperm previously were too weak or too few to fertilize in vitro (IVF), now have no problem fertilizing their wife's eggs. The fertilization rate per egg using ICSI is about 70% despite the sperm being terrible, the fertilization rate per infertile couple is over 99% if the wife has adequate eggs, and the pregnancy rate per treatment cycle is over 50%. This is not significantly different from regular IVF with normal sperm. This technique is very cost-effective, and will give you the same high chance for getting pregnant as any couple with normal sperm.
How Does ICSI Work?
Woman takes fertility drugs to stimulate her ovaries to produce more eggs, as for IVF. The eggs are then collected and each egg is injected with a single sperm from her husband.
If the husband can, he produce a fresh sperm sample on the same day as his partner’s eggs are collected. Otherwise sperm can be collected directly from the epididymis (a narrow tube inside the scrotum, where sperm are stored and matured) using a type of fine syringe. This is known as ‘percutaneous epididymal sperm aspiration’ or PESA or sperm can also be retrieved from the testicles, a process known as ‘testicular sperm aspiration’ or TESA. It is also possible to remove tiny quantities of testicular tissue from which sperm can be extracted. This procedure is called ‘testicular sperm extraction’ or TESE.
If man has a zero sperm count (other than caused by vasectomy), the chances of retrieving sperm surgically by PESA, TESA or TESE may be very low or at least uncertain. In this situation, if no sperm are retrieved; the options of having Donor insemination (DI) or In vitro fertilisation (IVF) with donor sperm can be considered instead.
After two to three days in the laboratory, fertilized eggs are transferred to woman's womb in the same way as for conventional IVF. It may also offer blastocyst transfer, where the fertilized eggs are left to mature for five to six days and then transferred.
Any suitable remaining embryos can be frozen for future use.