ICSI Intracytoplasmic Sperm Injection (ICSI) is a micromanipulation procedure in which a single sperm is injected directly into an egg to attempt fertilization, used with male infertility or couples with prior IVF fertilization failure.
The Process of IVF/ICSI – How is the IVF/ICSI done?
I. Basic Screening tests are performed on both partners.
In general, some testing of ovarian reserve should be done on the female prior to starting the injections.
We use AMH as gold standard as well as D2-3 FSH, E2, P4 and antral follicle counts for this purpose.
The results of these tests give us some information to predict her ovarian responses and also help us to administer to dose of injections.
II. Consents are signed by all parties
We use the consents form which is from The Royal Thai College of Obstetrician and Gynaecologists.
III. Controlled Ovarian Hyperstimulation
The woman is stimulated with injected medications to develop multiple follicles in the ovaries. Each follicle contains a microscopic egg. These injections continue to stimulate follicle and egg growth and development for about 8-10 days.
Blood test for hormone and ultrasound scan is done 1-2 times to monitor the development of the follicles.
After the follicles are in 16-18 mm. in diameter, injected medicine is used to trigger the final maturation. Then egg retrieval is performed 35-37 hours later.
IV. Egg Retrieval and fertilization
When a sufficient number of the woman’s follicles are mature, a transvaginal ultrasound-guided egg retrieval (egg aspiration) procedure is performed to remove the eggs from the follicles. At our IVF clinic, the average duration of the egg retrieval procedure is under 10 minutes, with a range of about 2-15 minutes. Powerful anesthesia medications are used so that the woman is “out” during this procedure and does not feel or remember anything.
Pictures of in vitro fertilization procedures Around the time of egg retrieval, semen is collected. In case of a male partner is not available, frozen sperm may be used. The eggs are then fertilized in the laboratory with her partner’s sperm. If the sperm (or the eggs) are of poor quality, the ICSI procedure might be used to aid in fertilization.
The embryos are cultured in the IVF laboratory for 2-6 days.
V. Embryo transfer
The embryo transfer procedure is done which places the embryos in the woman’s uterus where they will hopefully implant and develop to result in a live birth. This is like a Pap smear for the woman. There should be no discomfort.
If there are leftover embryos (of sufficient quality) beyond the number that is transferred, many couples prefer to have them frozen (cryopreserved) for use in a future cycle. Embryo cryopreservation can be used for another attempt at having a baby if the “fresh” cycle fails or as an attempt to have another child if the fresh cycle is successful.
We usually recommend the patient to be transferred only 1-2 embryos each time. We transfer routinely D5-D6 stage embryo, which is able to give highest success rate.
Day 5 IVF embryo at the blastocyst stage. The cluster of cells on the right side are fetal cells.
VI. Luteal Support After eggs retrieval
the woman is given medicines for luteal support.
The medicines comprise of 4-5 kinds varies from patient to patient.
The medicines have to be used until pregnancy test.
If the pregnancy test is positive, the woman has to continue the medicines until around 12 week gestation.
These medicines help embryo for implantation.
VII. Pregnancy test 10 days after embryo transfer
Pregnancy test 10 days after embryo transfer, the woman has blood test for pregnancy, the woman has blood test for pregnancy.
Success Rate
IVF live birth success rate statistics: success rates for IVF procedures vary considerably by the program handling the case. This is an important factor to consider and not well understood by many consumers of infertility and IVF services. Make sure that you discuss pregnancy and delivery success rates in detail with your doctor before you start a cycle.
You should ask about their pregnancy and delivery rates for couples similar to you (e.g. same age group and diagnosis).
at Safe fertility and PGD center, we achieve overall pregnancy rates around 40% in women under 40 years who using her own eggs.
However, cumulative pregnancy rate is around 80% within three cycles.
In egg donor program, the success rate is much higher.
The woman get pregnancy rate 60-70% at the first attempt and cumulative pregnancy is around 90% within three attempts.
What is different in success rate of fresh vs frozen embryo transfer?
Regarding to our statistic, we find that success rate of fresh embryo transfer is the same as frozen embryo transfer.