IVF with ICSI

In vitro fertilization, or IVF, has become a modern mean of treating infertility and reproductive problems in many couples. While IVF has been a solution in many difficult cases of infertility, it is not enough in other cases alone, prompting gynecologists, obstetricians and infertility specialists to rely on another method known as Intracytoplasmic sperm injection (ICSI), which involves injecting an egg from the wife with a sperm taken from the husband, facilitates fertilization and increases its success rate. ICSI is generally used to overcome male infertility problems, a fast and often safe technique with high success rates.

The period of time required for ICSI is approximately 30 days.

In vitro fertilization, supported by ICSI, may be used in one of the following cases:

• Failure of pregnancy after the repeated IVF procedure several times.
• In cases of sperm extraction or suction from the epididymis or testicle.
• High percentage of antibodies in the semen of the husband.
• Weak sperm movement.
• Low sperm counts.

One or both of the spouses undergo some of the previous tests to begin the procedure for IVF. These include the following:

• AMH test (Anti-Müllerian Hormone); to assess ovarian function and the ability to produce mature eggs for fertilization.
• FSH test (Follicle-stimulating hormone); to assess the wife's ovaries disorders and testicular problems in the husband.
• AFC test (Antral follicle count); to assess the number of primary eggs in the ovary (ovarian reserves).
• Ultrasound examination of the uterus to ensure the integrity of the inner lining of the uterus.
• Examination of the uterus and vagina through the endoscope by inserting it through the vagina.
• Examination of the husband's sperm to check their number, size and shape.

IVF with ICSI may involve the following complication for the wife:

• Bleeding.
• Infection.
• Defects in the fetus.
• Breasts become tender.
• Headache.
• Bloating.
• Cramps in the uterus.
• Ectopic pregnancy.
• Ovarian hyper-stimulation syndrome, very rare.
• Mood swings.
• Abortion.
• Sensitivity to certain medications.

IVF with ICSI consists of the following main steps:

1. Give the wife a set of stimulating injections for about 10 to 12 days starting from the second or third day of the menstrual cycle, with careful monitoring of the eggs through sonar or ultrasound, followed by different visits to the gynecologist and obstetrician to follow ovulation and measure the size and shape of the stimulated eggs.
2. Give an HCG injection to the wife to release the eggs.
3. Extract eggs 34 to 36 hours after the HCG injection, the wife is given a sedative to relieve pain and in some cases it is done with a general anesthetic effect, by inserting a very fine suction needle through the vagina to the ovary.
4. Take a sample of the husband's semen.
5. Injection of eggs with sperm under the microscope.
6. After 24 hours, fertilization of the eggs is observed, divisions are monitored, and embryos can then be returned to the uterus either on the third day after fertilization or on the fifth day.
7. The obstetrician and gynecologist use a catheter to insert the selected embryos through the vagina into the uterus.

*HCG injection is one of the most important steps during the IVF process, so it is very important to adhere to the dates given by the specialist and not neglect.

*The wife is advised to drink water or liquids to help fill the bladder, which facilitates the process of embryo transfer, thus raising the success rate of laboratory fertilization and pregnancy stabilization.

After IVF with ICSI, the wife is asked to wait approximately two weeks - depending on the age of the embryo when it is transferred - to have a pregnancy test (blood test not urine), as the results often appear after this period.

The wife can practice her normal life after IVF, but one of the important tips for the success of IVF is to make sure to avoid stressful activities and try to rest as much as possible, and abstain from sexual intercourse for about a week, also it is preferred to drink enough amounts of water.