IVF is inseminating retrieved eggs from the female with the sperm from the male which is collected and processed in the laboratory. The fertilized eggs are kept for 2-3 days in incubators and those that develop to good quality embryos are transferred into the womb.
How is it done?
Retrieved eggs are washed and placed in special fluids for fertilization and embryo development. The semen produced by the male is washed in the laboratory to remove the seminal fluid. This enables most of the dead or immotile sperm to be cleaned and good quality sperm to be concentrated. The preparation is assessed for the number, motility and morphology (shape) of the sperm. Sperm is brought to a concentration per egg and added into the fluid that contains the eggs. The day after (16-18 hours later) collection, eggs are examined under the microscope for assessment of fertilization and those that are normally fertilized are transferred into a new dish with fresh solution. Cleavage is then traced for the following 2-3 days and embryo qualities are scored. One or two best quality embryos are selected and transferred into the uterus. Remaining embryos with good quality are frozen after obtaining informed consent from the couple.
To whom IVF should be applied?
IVF can be applied to couples with certain criteria. Sperm and Oocyte qualities should meet certain standards. In cases with low sperm count, or poor morphology (shape) as with poor oocyte quality, fertilization can be compromised or even not occur at all. Therefore, IVF can be applied to couples with good sperm and Oocyte quality.
Intra-cytoplasmic sperm injection (ICSI) is one of the most widely used insemination method in assisted conception treatments. It is simply the injection of a single sperm cell into one egg. ICSI is especially useful in cases with low sperm count, or poor sperm morphology and also in cases where conventional IVF resulted in poor fertilization.
As ICSI is an easy technique and results in acceptable fertilization rates, it is widely used in most clinics around the world.
Under normal circumstances, sperm penetrates the egg membrane by the aid of its motility and certain organelles (structures). This fertilization procedure enables healthy sperm to be selected while those with abnormal genetic content will be eliminated. During ICSI however, sperm is selected by the embryologist so the selection of unhealthy sperm is impossible. While the risk should be kept to a minimum, it has to be remembered that embryos arising from unhealthy sperm (or the egg) will be eliminated during development.
To whom ICSI should be applied?
Cases which previously failed conventional IVF attempts, cases with low sperm count, and/or poor sperm morphology or motility, as well as those with poor egg quality can benefit from ICSI. First trial cases where sperm or the egg does not display any structural or physiological abnormality should try conventional IVF.