ICSI (intracytoplasmic sperm injection)

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ICSI (intracytoplasmic sperm injection)

Are you struggling with infertility and feeling the negative effects on your psychological health? Have you been dreaming of having a child to share your life journey with and leave a positive impact on your future? You have tried traditional methods without success; this article is for you.
What is ICSI?
ICSI is used to assist in conception when traditional methods have failed. The sperm fertilizes the egg outside the body. Several days later, it is transferred to the uterus as embryos, which greatly increases pregnancy chances.
Delayed pregnancy by traditional methods, how do I know if I need ICSI in Egypt?
If you have one or more of the following factors, then you can book through us and travel to Egypt to complete the ICSI:
1- Delayed wife age and absence of a natural pregnancy.
2- More than 3 years have passed since marriage if the wife is younger than 30), or one year at most (if the wife is older than 35) without a natural pregnancy.
3- Sperm problems could not be treated by a specialist doctor.
4- Problems in the wife, such as endometriosis, ovarian cysts, or low ovarian reserve.
5- Unexplained delay in pregnancy.
Before coming to Egypt for ICSI, what are the required procedures and tests?
We advise you to speak with the gynecologist you have chosen from our website to explain the case and send previous X-rays and tests and accurately determine the required needs. However, we can list some of the required examinations here as follows:
For the wife:
First: Tests:
1- FSH test: For accuracy, it is done on the second, third, or fourth day of the menstrual cycle. It is preferred to be less than 12. In the case of a higher ratio, it indicates a weakness in the ovarian reserve of the wife.
2- Prolactin level test: It is preferred to be less than 20.
3- Thyroid gland test (TSH): There is no specific time of the month to do this test. It is preferred to be less than 2.5.
4- Ovarian reserve test, or AMH: There is no specific time of the month to accomplish this test.
If the test ratio is 1 or more, this is a sign of good ovarian reserve. 
If the ratio is less than 1, it indicates a weakness in the ovarian reserve of the wife.

Second: Ultrasound:
In which your doctor checks the uterus and ovaries to ensure their initial safety.

Third: Hysteroscopy:
This step should not be overlooked, especially with a previous failure of ICSI. In this step, the safety of the uterus and ovaries is checked more accurately, and any problems that may hinder the success of ICSI, such as endometriosis or problems in the fallopian tubes, are ruled out. In this step, the surgeon can perform endometrial scratching on the uterine wall, which enhances the chances of the embryo attaching immediately after transfer to the wife's uterus.
In some cases, we may need to perform a laparoscopy if required, such as for a certain type of endometriosis that needs to be removed or for other medical reasons considered by the gynecologist.
For the husband:
Semen analysis:
To confirm the presence of viable sperm for successful ICSI. If the husband does not have sperm in the semen analysis, this is not the end, as sperm can be extracted from the testicle with a needle to complete the ICSI process in Egypt.
Specialists emphasize the necessity of conducting this analysis at a specialized fertility center, as it is done with greater accuracy and gives the desired results. If there are problems with the husband's analysis, it is recommended to treat them with an andrologist to increase the chances of success with ICSI.
DNA fragmentation testing:
It is usually not required in all cases, only in the case of a previous failure of ICSI of unknown cause or with significant problems in semen analysis.

How is the ICSI done step by step?
1- Preparing the wife:
Gynecologists in Egypt prefer to prepare the wife before performing ICSI by taking some necessary medications to help increase its success rates, such as:
- Antioxidants, such as Omega-3 drugs.
- Aspirin: to help with blood flow and thus avoid clots and miscarriages.
- Folic acid: to help with fetal division with health and safety.
The doctor may prescribe other medications for the wife if needed, such as drugs to improve the quality of the eggs.
2- Giving the wife some ovulation stimulants:
Gynecologists in Egypt determine the type and doses of the required stimulants for the wife, according to her condition and medical history after reviewing all the required tests and radiations.
The wife starts taking the stimulants according to the prescribed dose after the first 3 days of the menstrual cycle.
The required stimulants are mostly subcutaneous injections, preferably taken in the abdomen for ease or intramuscular injections.
3- Follow-up of ovulation:
During this stage, ovulation is monitored by ultrasound at the clinic, with close follow-up, usually every two or three days or according to your doctor's recommendation.
During these visits, especially the first ones, the prescribed doses of the stimulants are re-evaluated and adjusted if necessary.
The stable psychological state of the couple and the husband's support for his wife are very important during the ICSI period, starting from this step until blood analysis and confirmation of pregnancy, God willing.
Note: Ovulation drugs include two types: stimulating injections and inhibiting injections, and their role is to prevent the release of the egg after its maturity.
After reaching the required number and size of eggs, the wife is given a triggering injection, which is similar to the pregnancy hormone HCG, to prepare for the egg retrieval after 34 or 36 hours, so it must be taken at the prescribed time by your gynecologist.

Note: The effect of this injection in the blood continues for a week to 10 days, so it is never advisable to perform an early pregnancy test after transferring the embryos to the uterus so as not to obtain inaccurate results.
4- Egg Retrieval:
The eggs are retrieved in a specialized center or an equipped hospital.
- The wife is anesthetized with total anesthesia.
- The egg retrieval process takes only 30 minutes and is very easy.
- The egg retrieval process does not cause pain and is safe in Egypt.
- Do not forget to fast for at least 6 hours before the egg retrieval process.
- Do not forget to bring your and your husband's identification documents.
- Do not forget to bring your marriage certificate.
- Sexual intercourse is not allowed after this step until pregnancy is confirmed by your doctor, God willing.
5- Collection of semen samples from the husband:
- This step occurs on the same day as the egg retrieval, or the semen sample is brought if it was frozen.
- The readiness of the sample for intracytoplasmic sperm injection (ICSI) is confirmed before the husband and wife leave the hospital.
- If the sample does not contain viable sperm, we can take sperm from the husband's testis using a tiny needle.
6- Embryo Formation:
- A viable sperm is injected under the microscope into each egg capable of fertilization, so it is called intracytoplasmic sperm injection (ICSI).
- The embryos are then formed and left to divide in specialized incubators in equipped laboratories in Egypt until they are ready to be transferred back to the wife's uterus after 3 to 5 days, according to the gynecologist's opinion.
7- Embryo Transfer:
- After 3 to 5 days, healthy, divided embryos are transferred to the wife's uterus.
- The process is painless and does not require anesthesia.
- Rest for an hour or two, then leave.
- Sexual intercourse is prohibited, as we mentioned before.
- The wife's psychological state is very important at this stage.
8- Two weeks or 14 days of waiting, then pregnancy test:
- Minimal movement is allowed during the first 3 days, followed by cautious movement without effort until the end of this stage.
- We advise the wife not to worry about any symptoms as long as they are within the limits of cramps or abdominal and back pain.
- After 14 days, a digital pregnancy test is performed in the blood, and the urine pregnancy test is not recommended due to its inaccuracy.
If there is a pregnancy, God willing, the test is repeated after 48 hours.
- A ratio above 100 and its duplication every 48 hours indicates a good pregnancy, God willing.

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