Micro-Fertilisation
ICSI

What is
ICSI?


Intracytoplasmic Sperm Injection (ICSI) is a highly specialized form of in vitro fertilization (IVF) that has revolutionized the treatment of male infertility. Unlike traditional IVF, where many sperm are placed near an egg in a laboratory dish, ICSI involves the direct injection of a single sperm into an egg. This technique significantly enhances the chances of fertilization, especially in cases where male infertility factors are prominent.

How
ICSI Works?


ICSI is designed to overcome severe male infertility issues by facilitating fertilization at a microscopic level.
This method is particularly beneficial for men with low sperm count, poor sperm motility, or abnormal sperm morphology.
By bypassing natural barriers to fertilization, ICSI offers a viable solution for couples who might otherwise struggle to conceive.

Indications for
ICSI


ICSI is typically recommended in the following scenarios:

– Male Factor Infertility: Low sperm count, poor sperm motility, or abnormal sperm morphology.
– Previous IVF Failures: When traditional IVF methods have not resulted in fertilization.
– Unexplained Infertility: When no clear cause of infertility is identified despite thorough testing.
– Sperm Retrieval Issues: Cases where sperm must be surgically retrieved from the testes or epididymis.
– Genetic Concerns: To prevent transmission of genetic disorders that might affect the sperm’s ability to fertilize an egg naturally.

How ICSI
is Performed


The ICSI process involves several meticulous steps to ensure the best chances of successful fertilization.
The procedure is intricate and requires advanced laboratory techniques and equipment.

General Steps Involved in the
ICSI Procedure

1.Ovarian Stimulation

Similar to traditional IVF, the woman undergoes hormonal treatment to stimulate the ovaries to produce multiple eggs.

2.Egg Retrieval

Mature eggs are collected from the ovaries using a minor surgical procedure called transvaginal ultrasound aspiration.

3.Sperm Collection and
Preparation

Sperm is obtained either through ejaculation or surgical retrieval. The sperm is then processed to select the healthiest and most motile ones.

4.Micromanipulation

Under a powerful microscope, a single sperm is carefully injected into the cytoplasm of each mature egg using a fine glass needle.

5.Fertilization and Embryo Culture

The injected eggs are cultured in the lab and monitored for signs of fertilization and subsequent embryo development.

6.Embryo Transfer

Healthy embryos are selected and transferred to the woman’s uterus, where they can implant and develop into a pregnancy.

Safety of
ICSI


ICSI is generally considered safe and has been used worldwide for several decades. However, like all medical procedures, it carries some risks and potential complications. These can include:

– Ovarian Hyperstimulation Syndrome (OHSS): A reaction to fertility drugs that can cause swollen and painful ovaries.
– Multiple Pregnancies: An increased chance of twins or triplets, which can pose risks to both the mother and babies.
– Genetic Concerns: While rare, there may be a slight increase in the risk of genetic abnormalities due to the manipulation of sperm and eggs.

Despite these risks, ICSI has a high success rate and has helped countless couples achieve their dream of having a child.
Ongoing research and technological advancements continue to improve its safety and efficacy.

Greek Legislation
on ICSI


The Greek state has established comprehensive laws regulating the use and distribution of donor sperm. According to Greek legislation:

– Donor Age: Sperm donors must be adults under the age of forty.
– Fresh Sperm Use: The use of fresh donor sperm is prohibited.
– Single Donor Use: Only one donor’s sperm can be used per treatment cycle.
– Donor Anonymity Options: There are three options regarding donor anonymity:

1. Complete anonymity, where the donor’s identity remains confidential.
2. Complete transparency, where the donor’s identity is known.
3. Conditional transparency, allowing the child to access the donor’s identity upon reaching adulthood.

– Stringent Controls: Extensive clinical and laboratory testing of samples, meticulous tracking,
and verification of donor identity are mandatory.

Additionally, a national donor registry has been established, recording all donors from Greece and abroad.
This registry ensures that the legal limit on the number of children per donor is not exceeded and provides
a safeguard for the ethical management of donor contributions across all IVF centers in Greece.

In summary, ICSI offers a promising solution for many infertility issues, especially male factor infertility.
The process is complex and requires advanced medical expertise, but its success rates and safety profile make it a vital
component of modern reproductive medicine. In Greece, strict legal frameworks ensure that ICSI and related treatments
are conducted ethically and safely, providing peace of mind for prospective parents.