ICSI (Intracytoplasmic Sperm Injection) is the latest technique in infertility treatments. Single sperm is injected directly into an oocyte for the fertilization. It has the highest pregnancy rate which is around 55%. Woman's age, ovarian reserve , condition of the tubes and the uterus, man's sperm count are the main important factors in conceiving . Related tests should be completed before starting the treatment. After the evaluation of the results doctor will decide on how to proceed and then treatment will start.

What are the pre-treatment tests for ICSI?

1. Woman needs to have a gynegologic examination at any day of the cycle.

2. Woman needs to have hysterosalpingography (X-Ray of the fallopian tubes) on or around cycle day9.

3. Man needs to have sperm analysis.

Apart from the above tests the couple completes a medical questionnaire. According to the information couple provides and the test results, additional tests/surgeries can be required.
Please keep in mind that pregnancy rate differs according to the test results mentioned above.

ICSI treatment has 3 steps:

1. Ovulation Induction:

ICSI treatment starts between cycle day 2 - 5 with the vaginal examination to see how the ovarian reserve is and what the endometrium thickness is and if there is any cyst, fibroid or other pathology in the uterus. If the result is normal patient starts to have subcutaneous(self administered) hormone injections. Upon request all the injections can be done by the nurses at the hospital.

Patient continues to have the injections for 4-5 days and have another examination to see how the ovarian response is. Also Estradiol and Progesteron levels are checked. According to the results the doctor decides the dose of the injection and patient comes for another examination in 2-3 days.

These examinations and the injections continue until patient has mature follicles ( around 18 mm – 19 mm). HCG injection (trigger) is given to prepare the patient for the Occyte Pick Up (OPU) procedure.

2. OPU:

It is performed 35-36 hours after the HCG injection and under light anesthesia (sedation). Oocytes are collected from the both ovaries. The partner provides sperm sample and embryologist performs ICSI (injecting 1 sperm into each mature oocyte) for the fertilization. The doctor informes the couple about the number of oocytes obtained, the nurse prescribes the medications and patient is discharged on the same day.

3. Embryo Transfer:

Patient is informed about the fertilization the next day and according to the number of embryos and their quality, embryo transfer is performed on the 2nd, 3rd or the 5th day. Patient is awake during the procedure and discharged on the same day.

According to Turkish Health Goverment, we transfer one embryo under 35 years of age in the first or second treatment cycles and two embryos in the third or further cycles or for 35 and older ages.

Patient has Beta HCG pregnancy test 12 days after the embryo transfer.

What if patient does not have a chance to travel Istanbul for 3 weeks?

The whole treatment lasts for 3 weeks. If the couple does not have a chance to stay in Istanbul for 3 weeks then the firts step of the treatment can be completed in their country with a local clinic and travel to Istanbul for 10 days.

The local clinic should provide the ultrasound report, estradiol and progesterone results on the same day. Our doctor will advise about the results and the dose of the medications.

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