- What is IVF (In vitro fertilization)?
- ICSI (Intracytoplasmic sperm injection)
- What is the ICSI procedure?
- ICSI vs. IVF: Which one is better?
- How long does the ICSI procedure take?
- Who benefits from ICSI?
- What are the success rates of ICSI?
- What is the disadvantage of ICSI?
- What is the advantage of ICSI?
- Where is the best venue for ICSI?
- ICSI at MedPark Hospital
- Watch the video: Things to know before doing ICSI
- A specialized medical team
- FAQ
- IVF/ICSI Package
- Online consultation with specialists
What is IVF (In vitro fertilization)?
IVF (In vitro fertilization) is an assisted reproductive technology for infertile couples by collecting the father's sperm and the mother's fertile eggs for fertilization in an embryology laboratory and then transferring the resulting embryo back into the mother's uterus to continue growing until a baby is delivered. IVF is the most effective assisted reproductive technology currently available. Millions of infertile couples, including men with unhealthy sperm or women aged 35 and up with low egg counts, can now have a chance of becoming pregnant and having a baby, fulfilling their dream of a complete family.
ICSI (Intracytoplasmic sperm injection)
ICSI is a specific assisted reproductive technologies (ART) technique of in vitro fertilization (IVF). ICSI involves selecting the most potent, single sperm with the best motility and injecting them directly into a fertile ovum with a micro-needle for assisted fertilization. The embryo is then cultured in a sterile embryology laboratory until it reaches the stage of day-5 embryo (Blastocyst). The following uterine transfer of the blastocyst allows continuing development in the womb. ICSI is accepted as a safe and highly effective medical technology for men with male-factor infertility, such as unhealthy sperm, low sperm count, and women with low egg counts, thick eggshells, or an unhealthy uterus, to have a successful pregnancy outcome.
What is the ICSI procedure?
Pre ICSI Procedures
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Physical examination
Before proceeding to the ICSI procedure, the obstetrician will conduct a thorough physical examination to assess the mother-to-be's health readiness. The obstetrician will schedule an appointment coinciding with the 2nd or 3rd day of the menstrual period for a blood test to evaluate the ovarian functions, including an ultrasound examination to count the number of eggs in each menstrual cycle to calculate the dose of hormone required for ovarian stimulation, taking into consideration the physical health, age, and the results of the physical exam.
- Ovarian stimulation
When the physical examination indicates readiness for ICSI, the obstetrician will begin the ovulation induction process by daily injection of hormones to stimulate multiple egg growth and maturation to be ready for fertilization at the same time. Usually, the eggs will fully mature 8-14 days after the first hormone injection.
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Monitoring the growth of oocytes
The obstetrician will perform periodic transvaginal ultrasounds to count the number of eggs and check the growth of the follicles to see if they have fully expanded. Then the obstetrician will inject hormones to stimulate oocyte maturation and prepare for egg retrieval in 34–36 hours.
- Egg retrieval
Once eggs are ripe for retrieval, the obstetrician will retrieve the eggs under light sedation by inserting a thin needle through the vaginal wall under ultrasound guidance into the targeted egg follicles, piercing the follicle wall to collect the eggs, and transferring them to the egg culture media until they are ready for fertilization. Typically, the egg retrieval process takes approximately 20–30 minutes.
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Sperm collection
On the same day as the female's egg retrieval, the obstetrician also schedules a sperm collection appointment for the male partner. If it is inconvenient for the male partner, he can come beforehand for sperm collection, with the sperm kept frozen until the female is ready for egg retrieval. For the best possible sperm, the obstetrician will advise the male to refrain from sexual intercourse, masturbation, and all manners of ejaculation for approximately 2-3 days before the sperm collection date.
On the day of sperm collection, the obstetrician will ask a father-to-be with normal reproductive function to masturbate into a sterile container in a private room for men. Within 60 minutes, the ejaculate will go to an embryology laboratory for semen analysis. The embryologist will select the healthiest and strongest sperm with excellent mobility and nourish them in a nutrient solution to nourish and enhance sperm mobility before injecting the sperm into the egg for fertilization.
For men with male-factor infertility, complete absence of sperm, such as obstruction of sperm carrying duct, azoospermia (OA), or anejaculation, the urologist will use a small needle to aspirate sperm from the testicle with Percutaneous Epididymal Sperm Aspiration/Testicular Sperm Extraction (PESA/TESE) before injecting a sperm into the egg to facilitate fertilization. This method allows those with unhealthy or weak sperm unable to penetrate the outer eggshell to enter the eggs directly.
Procedure during ICSI
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ICSI fertilization
The embryologist selects healthy mature eggs and places them on the lab dish, holding an egg firmly in place with a pipette, then sucking up a single healthiest sperm into the tip of a thin glass needle before injecting it into the egg to achieve fertilization.
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Embryo culture
After successful fertilization, the embryologist will culture the embryo for 3-5 days. The fertility doctor and embryologist monitor the embryo development for the cell division from 1 cell > 2 cells > 4 cells > 8 cells > 32 cells to over 100 cells coalescing in a compacted stage embryo until they reach the blastocyst stage on day five after fertilization.
The embryologists culture the embryos in a specialized nutrient solution under the controlled environment of the embryology laboratory for temperature, humidity, gases, and pH, similar to the conditions within the mother's womb, to facilitate embryo growth before proceeding with the embryo grading and embryo transfer procedures.
Post ICSI Procedures
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Embryo transfer
The embryo transfer into the uterus is of two types: 1.) fresh embryo transfer and 2.) frozen embryo transfer.
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- Fresh embryo transfer (ET) places the embryo into the uterus during the same induction-ovulation cycle. Typically, the fertility doctor will perform embryo transfer 5–6 days after the egg retrieval after it has reached the blastocyst stage. The embryo must have good growth and development reaching this stage, and the mother-to-be's condition must be pregnancy-ready. The fertility doctor will use a trans-abdominal ultrasound to guide the placement of the embryo into the uterine cavity for implantation and pregnancy to safely take hold.
- Frozen embryo transfer (FET) the embryo transfer happens in a subsequent ovulation cycle to avoid the side effects of ovarian hyperstimulation syndrome (OHSS), endometrial hyperplasia, or edema. The embryo will be frozen and thaw when the mother's physical condition is ready to proceed with the transferring procedure in a subsequent ovulation cycle.
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Pregnancy test
The fertility doctor will schedule a pregnancy test approximately ten days after the embryo transfer procedure. The obstetrician will check for pregnancy with a blood test to measure beta-HCG hormone levels and assess other conditions. When the pregnancy is confirmed, the mother-to-be will proceed with the standard antenatal care process. The obstetrician will schedule follow-up appointments to check the mother-to-be's overall health, including ultrasounds to monitor fetal development inside the womb at regular intervals.
ICSI vs. IVF: Which one is better?
IVF and ICSI are effective IVF procedures, enabling infertile couples to have children. The fertility doctor will determine the best IVF solution for each married couple based on the ovulation test result and sperm robustness. Eggs with thick shells or weak or poor motility sperm may prevent the sperm from penetrating the ovum; ICSI helps bypass both hurdles since the procedure involves injecting sperm directly into the egg to achieve fertilization and conception.
How long does the ICSI procedure take?
Usually, an ICSI cycle takes approximately 4-6 weeks, starting with a physical examination, a blood test to measure hormone levels, and a series of hormone injections for ovarian stimulation for 9-10 days. The egg retrieval and sperm collection take half a day, followed by 5–6 days of embryo culture in an embryology laboratory. If there are good-quality embryos, the fertility doctor will schedule the embryo transfer for its further growth and development in the mother's uterus into a fetus.
Who benefits from ICSI?
ICSI offers a great deal of benefits to those with the following infertility conditions:
- Female-factor infertility, e.g., endometriosis, hydrosalpinx, ruptured or blocked fallopian tubes, anovulation, ovulation disorders, reproductive system diseases, and other disorders
- Male-factor infertility due to obstructive azoospermia (OA), anejaculation, varicocele, and other abnormalities
- Women over 35 with low egg quantity and quality or thick eggshells that sperm cannot penetrate.
- Women who have had sterilization by tying, cutting, or blocking fallopian tubes
- Men with low sperm count, poor sperm quality, or poor morphology
- Men who have undergone vasectomy procedure
- Couples who have failed other infertility treatments, such as IVF or IUI
- Those who have banked their frozen eggs and want to conceive (Oocyte cryopreservation).
What are the success rates of ICSI?
Compared to other infertility treatment methods, ICSI is currently the most effective IVF method for treating infertility and is widely accepted worldwide. The success rate is as high as 60–70% (if transferring genetically tested embryos). The essence of the ICSI technique is to inject sperm directly into the egg for fertilization, bypassing infertility issues caused by thick eggshells or poor-quality sperm, which enhances the chances of a successful pregnancy.
What is the disadvantage of ICSI?
Since performing Intracytoplasmic Sperm Injection (ICSI) is a complex, multi-step treatment -- conducted in a specialized laboratory-- for addressing fertility issues, it is advisable to opt for ICSI at a hospital with high standards, readiness, expertise, and experience in managing unforeseen circumstances effectively, if they arise.
What is the advantage of ICSI?
The advantage of ICSI is widely recognized: the procedure yields a satisfactory fertilization result to assist those with infertility, reproductive system diseases, genetic disorders, or those who have failed other IVF procedures. The advantages of ICSI include the following:
- ICSI increases the chances of fertilization when compared to other IVF procedures by allowing sperm to freely fertilize the eggs without having to penetrate the egg itself.
- ICSI reduces the risk of an inherited disorder passing down to the fetus, such as Down syndrome or thalassemia.
- ICSI allows men with low sperm counts, poor morphology, poor sperm quality, or infertility to have children.
- ICSI increases the chances of pregnancy for women over 35 who are infertile to have a better chance of becoming pregnant.
- ICSI enables couples who have undergone sterilization procedures, such as fallopian tubes or spermatic duct ligation, to have a successful pregnancy without sterilization reversal procedures.
- ICSI allows couples to conceive and have children later in their lives when they are ready.
Where is the best venue for ICSI?
Your chances of a successful pregnancy are more likely by undergoing ICSI at an internationally accredited hospital (JCI) with a team of experienced reproductive medical professionals in the diagnosis and treatment of infertility to help guide you toward achieving a successful pregnancy; a leading hospital that provides informative advice, ensuring you remain well-informed every step of the way throughout your treatment journey; a reputable hospital upholding stringent sanitary protocols and utilizing cutting-edge medical technology while prioritizes a caring approach at every step, from meticulously planned treatment strategies to the delicate nurturing of embryos within the embryology laboratory to a successful pregnancy until the day your baby graces the world.
ICSI at MedPark Hospital
MedPark Hospital in Bangkok, Thailand, stands as a beacon of excellence in the fields of reproductive medicine and the treatment of infertility. MedPark IVF Center: Redefining Fertility Treatment Journey, led by a team of highly-seasoned physician specialists in Reproductive Endocrinology and Infertility—leveraging cutting-edge assisted reproductive technologies and a world-class embryology laboratory, is dedicated to diagnosing and treating infertility through a holistic approach offering comprehensive care that spans personalized treatment strategies to the delicate embryos nurturing in a global-standard laboratory environment. With an unwavering commitment to patient well-being, MedPark Hospital's distinguished center for infertility and reproductive technology ensures meticulous attention and comprehensive support throughout the treatment journey. This unswerving dedication aims to guide couples toward the culmination of their dream of parenthood.
Get to know a specialized medical team
at MedPark IVF Center
| Assoc.Prof.Dr Suphakde Julavijitphong Infertility and Reproductive Gynecologist |
Dr Viwat Chinpilas Infertility and Reproductive Gynecologist |
| Dr Pimpagar Chavanaves Infertility and Reproductive Gynecologist |
Assist.Prof.Dr Porntip Sirayapiwat Infertility and Reproductive Gynecologist |
| Dr Punkavee Tuntiviriyapun Infertility and Reproductive Gynecologist |
Dr Chanakarn Suebthawinkul Infertility and Reproductive Gynecologist |
| Dr Chayanis Apirakviriya Infertility and Reproductive Gynecologist |
Dr Piphat Jongkolsiri Infertility and Reproductive Gynecologist |
FAQ: What you need to know about IVF/ICSI?
- What is the success rate of IVF/ICSI?
The success rate of IVF/ICSI treatments depends on several factors, including the patient's overall physical readiness, such as egg, sperm, endometrium, and embryo quality, and encompasses the laboratory's preparedness. Generally, the pregnancy success rate per embryo transfer ranges from approximately 30% to 40% without preimplantation genetic testing (PGT). However, with PGT, the pregnancy success rate can reach 60% to 70%. At MedPark IVF, our physicians and scientists team collaboratively assess, evaluate, and personalize treatment plans to maximize the patient's chances of a successful IVF/ICSI procedure. - Are test-tube babies weaker than naturally conceived babies?
Based on research data from the past 30 years, there is no evidence to suggest that children born through IVF/ICSI have a higher incidence of disabilities compared to naturally conceived children. - How does EmbryoScope Plus increase the success rate of IVF/ICSI?
The EmbryoScope Plus is an incubator that utilizes Timelapse technology to capture images of embryos every 10 minutes, creating a continuous video sequence. This allows scientists to observe and assess the embryos qualities without removing them from the incubator, minimizing disturbance to the embryos. Additionally, incorporation of artificial intelligence (AI) algorithms aids in the evaluation of the Timelapse videos. The iDaScore, derived from the AI algorithms, correlates with the success of pregnancy outcomes. - Does Embryo Glue increase the success rate?
Embryo Glue, also known as embryo adhesive, is a type of protein called Hyaluronan, which is naturally present in the endometrium during the natural implantation process. There are currently several research studies that show the positive effects of Embryo Glue in improving pregnancy rates. However, data on Embryo Glue is still in its early stages and require further research for additional validation in the future. - What are the benefits of Preimplantation Genetic Testing (PGT) for embryos?
After obtaining embryos through IVF/ICSI, scientists can extract a few cells from the embryos for genetic testing, known as Preimplantation Genetic Testing (PGT). It offers several advantages:- Selection of embryos with normal chromosomal numbers: PGT helps identify embryos with a normal chromosomal count for transfer, increasing the implantation and pregnancy rate, reducing miscarriage rates, and lowering the risk of having a child with chromosomal abnormalities.
- Genetic screening for inherited diseases: In cases where one or both partners have a history of genetic diseases, such as Thalassemia, genetic testing of embryos allows the identification of unaffected embryos, ensuring the transfer of embryos free from the genetic disorder.
Overall, PGT plays a crucial role in improving the success rates of IVF/ICSI by selecting genetically healthy embryos and reducing the risk of passing on inherited diseases.
- Does Preimplantation Genetic Testing (PGT) pose a risk of increased birth defects?
Currently, Preimplantation Genetic Testing (PGT) involves extracting a small number of trophectoderm cells (5-10 cells), destined to develop into placenta, from embryos. This procedure does not significantly interfere with the overall development of the embryo/fetus. There is no evidence to suggest, based on current data, that genetic testing of embryos using PGT increases the risk of birth defects in the examined fetus. - How does embryo grading affect the success of pregnancy?
Embryo grading involves assigning scores to embryos based on their external characteristics, cell division rates, and developmental progress. In the past, it was believed that embryos with higher grades were more likely to result in successful pregnancies. However, current research suggests that solely relying on external grading may not always accurately predict pregnancy success. - Can a woman with both fallopian tubes blocked still achieve pregnancy?
If both fallopian tubes are blocked, pregnancy is still achievable through Intracytoplasmic Sperm Injection (ICSI). In ICSI, eggs are retrieved and fertilized with sperm in a laboratory setting before transferring the resulting embryos into the uterus. This process bypasses the need for the fallopian tubes to facilitate pregnancy. Therefore, even if both fallopian tubes are blocked, IVF/ICSI offers a potential pathway to pregnancy. - Can a woman who has undergone tubal ligation have a child through ICSI?
Tubal ligation in women involves the blocking and dividing the fallopian tubes. IVF/ICSI can still be performed successfully in such cases, as the IVF process involves retrieving eggs and fertilizing them with sperm in a laboratory setting before transferring the resulting embryos into the uterus. This procedure bypasses the need for the fallopian tubes to achieve pregnancy. Therefore, even if a woman has undergone tubal ligation, IVF/ICSI offers a potential pathway to having a child. - Is it better to transfer embryos fresh or frozen?
With advancements in cryopreservation technology, research indicates that frozen embryo transfers generally have higher pregnancy success rates than fresh embryo transfers. This is likely because in fresh cycles, the hormone levels in women stimulated for egg retrieval are higher than natural levels, resulting in an unfavorable endometrium environment for embryo implantation.
IVF/ICSI Package
IVF/ICSI Package (In Vitro Fertilization/Intracytoplasmic Sperm Injection) is advance method of fertilization using laboratory procedure where a single strong sperm is injected directly into each egg. This yields satisfactory fertilization results.
IVF/ ICSI Package
Price 279,999 THB (Deposit 30,000 THB)
Turn your dreams into reality. Let's talk about your family's success story!
MedPark IVF Center:
Redefining Fertility Treatment Journeys
20th Floor, Counter A (WEST Lift)
Monday - Friday 8:00 am.- 8:00 pm.
Weekend 8:00 am.- 4:00 pm
Tel. 02-090-3020
