ICSI Procedure

Injection Needle For Oocyte Manipulation

For the ICSI procedure itself, an inverted microscope equipped with micromanipulators and microinjectors should be available 63 . Magnification capability of 200 x and 400 x is a prerequisite for precise procedures such as ICSI. A heating stage on the inverted microscope maintains the temperature at 37 C. Ambient temperature control is of vital importance for the survival of oocytes, which are very sensitive to a decrease in temperature that can cause irreversible damage to the meiotic spindle...

Fertilization and Embryo Cleavage After ICSI

Fertilisation Polar Bodies Cleavage

After the injection procedure, oocytes are rinsed and cultured in micro-droplets covered with lightweight paraffin oil. The conditions are similar to those employed for IVF inseminated oocytes the oocytes are kept at 37 C in an atmosphere of 5 O2, 5 CO2, and 90 N2. Injected oocytes are examined for integrity and fertilization about 16-18 hours after ICSI 67 . An average damage rate of approximately 9 of the injected oocytes can be expected, irrespective of the origin of the sperm used 45 ....

Types of Media for Embryo Culture

Culture media employed for clinical IVF vary greatly in their composition, yet there appears to be little difference between media in their ability to support development of the human embryo in vitro for up to 48 hours or in subsequent pregnancy rates after transfer 12 . This has led to a great deal of confusion concerning the formulation of embryo culture media and the role of individual components in embryo development. An understanding of the role of culture media and their components has...

Testing Ovarian Reserve

Chance Pregnancy Age And Fsh

Atlanta Center for Reproductive Medicine, Atlanta, Georgia, U.S.A. Both the quantity of eggs and their quality are strong influences on IVF outcome. Markers of ovarian reserve, such as basal follicle-stimulating hormone FSH and basal antral follicle BAF counts, are good predictors of the quantity of eggs which can be induced to grow. However, the quality of those eggs seems better predicted by the age of the women. In women past age 40, current success rates are low overall, even among those...

Endometrial Thickness and Pattern for Assessing Endometrial Receptivity

Ovarian Follicle Aspiration Needle

Ultrasonography has been used, with varying degrees of success, to correlate the probability of pregnancy in ovarian stimulation-ovulation induction cycles and IVF cycles 73-77 . Most imaging studies have been attempting to predict the probability of implantation. A thicker endometrium was observed on the day of oocyte retrieval in women who conceived during that cycle 74 . The IVF pregnancy rate increased in cycles when the endo-metrium was gt 9 mm but lt 14 mm 75 . In another study, no...

Indications for ICSI

Before the era of ICSI, attempts were made to modify and refine conventional IVF to achieve increased rates of conception in cases of male-factor infertility. Today, ICSI has clearly overshadowed the use of modified IVF procedures including high insemination concentration for the treatment of severe male-factor infertility. ICSI requires only one spermatozoon with a functional genome and centrosome for the fertilization of each oocyte. Indications for ICSI are not restricted to impaired...

GnRH AgonistFSHLong Downregulation Protocol

This protocol Fig. 2 is currently the protocol of choice for first cycle patients and previously normal or high responders in many IVF programs. A GnRH agonist Leuprolide, 1 mg SC, Buserelin 600 mg SC or Nafarelin acetate Synarel , 400 mg nasal spray, is given for 10-14 days before starting gonadotropin treatment long-protocol , and may be commenced in the mid-luteal phase of the previous cycle or on day 2 of the cycle. We, in addition to other researcher found that pituitary suppression was...

Gamete Handling Prior to ICSI

Germinal Vesicle

A successful ICSI program depends on ovarian stimulation, which is essentially similar to methods used for conventional IVF. Current ovarian stimulation regimens use a combination of gonadotropin-releasing hormone GnRH agonists or antagonists, human menopausal gonadotropin hMG , or recombinant follicle-stimulating hormone recFSH , and human cho-rionic gonadotropin hCG , which allows the retrieval of a high number of cumulus-oocyte complexes 43,44 . Administration of GnRH agonists allows for...

Intracytoplasmic Sperm Injection History of ICSI

Extremely low sperm counts, impaired motility, and abnormal morphology represent the main causes of failed fertilization in conventional IVF. Today, ICSI is the ultimate option to treat these cases of severe male-factor infertility. One single viable spermatozoon, preferably of good morphology, is selected by the embryologist and injected in each oocyte available. ICSI is based on micromanipulation of oocytes and spermatozoa. Initially, partial zona dissection PZD was established to facilitate...