IVF, ICSI and internal injection

Written By The HealthMeth Team - Updated On Monday, February 14, 2022 12:00 PM

What is microscopic insemination

ICSI is roughly the tube baby and is done as follows:

  • Stimulation of the ovaries to produce the largest possible number of eggs by needles of different hormones depending on the situation (intramuscular and hypodermic needles).
  • The stimulation of the ovaries is necessary because it increases the number of eggs, which increases the likelihood of developing more embryos and thus the success rate is higher than having only one egg.
  • The number of eggs and the size of the eggs are calculated (ovulation monitoring) by means of a vaginal ultrasound with follow-up visits to the doctor. It is also possible to perform a blood hormone test to find out the number of mature eggs in the late stages of activation.
  • The number of oocytes formed should be more than three. If the ovary produces less than that, the process is postponed to the next cycle to give a better chance of pregnancy. But if ovulation occurs before the eggs are collected, the process is postponed to the next cycle (and therefore the needles are given under the skin).
  • When the number and size of eggs reach the required limits, the steroids are stopped while keeping the needles under the skin, and a needle is given to achieve maturation of the eggs and then withdraw them.
  • The eggs are removed without making a surgical incision, where the eggs are withdrawn by a vaginal ultrasound machine (sonar), the bladder must be empty, and the patient must be prepared usually half an hour before the drug is given. The patient is not aware of the procedure and does not feel pain. Some doctors remove eggs without anesthesia. This is possible, but painful, for the patient, who may move from their place and consequently damage to the adjacent pelvic organs (intestine, bladder or blood vessels) may occur, which may require major surgical intervention.
  • The vagina is cleaned with a sterile material to extract the eggs. After that, ultrasound is inserted into the vagina. And the process of removing eggs gradually from the ovary by a sharp and long needle by the attending physician. Regardless of the number of eggs withdrawn, the process takes 5-30 minutes.
It must be noted here that not every vesicle drawn contains an egg, because 70% of the vesicles withdrawn only contain eggs.
  • After the completion of the withdrawal of all the vesicles, you must lie down for an hour in the center after the operation in order to restore complete alertness and ensure the patient's eligibility to go out to the home and the stability of his health.
  • A fluid is sent to all the vesicles to the laboratory to check the presence of eggs, their number, and their degree of maturity. This is done directly during the withdrawal of the vesicles.
  • The woman begins to take hormone therapy (progesterone) starting from the day of the collection of the vesicles in the evening.

side effects

1. Pain (cramping) similar to menstrual pain for a period ranging between 24-48 hours after egg collection.

2. If severe bleeding occurs, see a doctor. But if the bleeding is light, that is not a cause for concern.

3. The possibility of bacterial infection (infection) during egg collection.

In general, if the woman feels that she is unwell, she must see a doctor immediately.

Some serious side effects may occur, but they are few and may require surgery from the abdomen.

After the eggs are collected, a sample of semen is taken on the same day as the eggs are collected and the semen is prepared by separating the good sperm and placing them in a special fluid that helps them move, and perhaps adding some drugs that increase their activity. It is also possible to use semen that has been frozen in advance due to social circumstances (such as having to travel due to work conditions) or sickness of the husband.

Fertilization of the egg in the laboratory by adding sperms to the eggs in a special dish. This incubation period ranges from 4-24 hours, depending on the degree of maturity, then examined with a microscope (microscope) the day after fertilization to see whether or not fertilization has occurred. After the eggs are collected, they are placed in the environment or the environment that feeds the eggs, and at the same time the semen is prepared and about (100,000) sperms are taken. .

The time between egg maturation and the addition of semen depends on the extent of egg perfusion, noting that the special environment that we mentioned (the incubator) has a temperature similar to that of the mother, as well as the amount of oxygen. The embryos are usually transferred two to five days after the fertilization process, and the number of embryos transferred is usually one or two by inserting a tube through the cervix into the uterus, and then the embryos are placed in the uterine cavity in a certain way.

As for the method of artificial insemination (internal injection), it is different, as stimulating needles are given to stimulate the ovaries to produce from one to three eggs until they reach the required size. After the ovum has reached the desired size (from 18 to 20 mm) a burst needle is given. After 36 hours, the semen injection is performed, where two hours before that a semen sample is taken (the husband must abstain from sexual intercourse for two to five days before the time of taking the sample) and purify it and take the good from it and put it in a special injection. Then the semen is injected into the uterus or fallopian tube and the patient is asked to lie on her back for half an hour to an hour in the hospital, and then she can go about her life normally without exerting too much effort or carrying heavy.

Knowing the occurrence of pregnancy

Two weeks after the date of the embryo transfer or internal semen injection and without a period, a hormonal blood pregnancy test should be performed to confirm the occurrence of pregnancy, and pregnancy can be seen three to four weeks after the embryo transfer through the vaginal or abdominal ultrasound machine.

Freezing benefits

  • The rate of fertilization with frozen sperm is higher than fresh.
  • The percentage of getting pregnant with frozen embryos is higher than fresh.

When returning frozen embryos

  • The cost is lower because the stimulation needles are not taken and the egg retrieval procedure is not performed
  • The physical effort is less for not going to get the needles every day and for not undergoing the egg retrieval process
  • The health risks are lower by not subjecting to daily needles, not subjecting to anesthesia when retrieving eggs, not experiencing the risk of extraction (damaging neighboring organs), and giving time for the ovaries to stabilize after the critical stimulation period, which may cause serious ovarian irritation.

Dr. Abdel Raouf Riad