Intracytoplasmic Sperm Injection Overseas: Medical Tourism Makes it Possible

Intracytoplasmic Sperm Injection (ICSI)

ICSI (Intracytoplasmic Sperm Injection) is a highly specialized technology of assisted reproductive technology (ART) that can be employed in the management of infertility, particularly in situations of male factor infertility or when other forms of IVF have failed.

What is ICSI?

ICSI is a direct injection of a healthy sperm into the cytoplasm of a mature egg (oocyte) with a fine glass needle under a powerful microscope. This circumvents numerous physiological obstacles to the fertilization process including low sperm motility or morphology.

When is ICSI Recommended?

ICSI may be recommended in the following cases by doctors:

• Extremely small number of sperm (oligospermia).
• The sperm motility (asthenozoospermia) is poor.
• A deformed sperm (teratozoospermia).
• Obstructive or non-obstructive azoospermia (sperm obtained by surgery of the testes/epididymis).
• IVF cycles have failed to get fertilized.
• Frozen sperm (motility can be poor).
• Use of donor eggs.
• Infertility has no explanation.

ICSI fertility treatment

• Ovarian stimulation - Woman is on fertility drugs to generate several eggs.
• Egg retrieval - Eggs are removed off the ovaries through minor surgical operations.
• Sperm harvesting - Fresh ejaculation or surgical recovery (TESA, PESA, MESA, or TESE).
• Sperm injection -A single sperm is injected into the eggs that have matured with the help of micromanipulation.
• Fertilization check- Fertilization is checked after 16 to 20 hours.
• Embryo culture - Fertilized embryos (embryos) are grown in 3-5 days.
• Embryo transfer - The highest-quality embryo(s) are inserted into the uterus of the woman.
• Pregnancy test- Blood test (b-hcg) is completed approximately 14 days after embryo transfer.

ICSI procedure for infertility

The following is a step by step description of the ICSI (Sperm Intracytoplasmic Injection.) infertility procedure:

Ovarian Stimulation (Controlled Ovarian Hyperstimulation)

• The woman is given hormonal injections (FSH, hCG) to trigger the ovaries.
• Goal: Have more than one mature egg per cycle.
• Checks through ultrasound and blood tests.

Egg Retrieval (Ovum Pick-Up / OPU)

• Was carried out in a light anesthetic state.
• A fine needle with ultrasound is used to harvest the eggs in the ovarian follicles.

Sperm Collection

• On retrieval a new semen sample is taken.
• In case no sperm in semen (azoospermia) then sperm is removed surgically through:
• TESA - Testicular Sperm Aspiration.
• PESA Percutaneous Epididymal Sperm Aspiration.
• TESE/MESA -Testicular or Microsurgical Epididymal Sperm Extraction.

Sperm Selection

• Special techniques (e.g., density gradient, microfluidics) are used by embryologists to select the best quality motile sperm.

Intracytoplasmic Sperm Injection

• Micropipette holds each mature egg.
• The injection of a single sperm directly into the egg is done with micro-needle under the microscope.
• This gets in the way of the natural fertilization barriers.

Embryo Development, Fertilization

• Fertilization is verified 16 to 20 hours later.
• The fertilized eggs (zygotes) are successfully cultured in the lab over a period of 3-5 days until they mature to the cleavage or blastocyst stage.

Embryo Transfer

• Selection of the embryo of the best quality is done.
• Placed into the womb of the woman through a soft catheter (painless, non-surgical process).

Luteal Support

• The hormonal drugs (progesterone, estrogen) are administered to help in supporting the uterine lining and implantation.

Pregnancy Test

• A β-hCG blood test is a confirmatory test of pregnancy after approximately 14 days.
• In case of success, an ultrasound will be performed after 2-3 weeks to check heartbeat.

Factors Affecting ICSI treatment cost in India

The determinants of ICSI (Intracytoplasmic Sperm Injection) treatment price in India:

Fertility Clinic/Location Type

• Metro cities (Delhi, Mumbai, Bangalore, Chennai, Hyderabad, Gurgaon, Pune) tend to be costlier than the smaller cities.
• Even top hospitals and fertility chains worldwide are more expensive than local standalone IVF clinics.

Experience and Technology of the doctor

• Internationally trained or more successful fertility specialists can be more expensive.
• They can be expensive because of the use of experimental labs, micro-manipulation devices, incubators of large embryos, or time-lapse images of the embryo.

Diagnostic Tests & Pre-Treatment Evaluation

• There are added costs of hormonal tests, ultrasound scans, semen tests and genetic tests (where necessary).
• Genetic testing (such as Y-chromosome microdeletion, karyotyping) may be required in cases of male infertility.

Ovarian Stimulation Drugs

• One of the largest cost elements is hormonal injections (gonadotropins).
• The price is relative to the type of drug (imported and Indian) and number of cycles required.

Egg Retrieval, Embryo Transfer Procedures

• The anaesthesia, operating room and embryologist fees are standard charges.
• There can be extra charges on blastocyst transfer (Day 5 embryos) over Day 3 transfer.

Sperm Collection Procedures (where necessary)

• Surgical sperm retrieval is an additional cost in the event of azoospermia:
• TESA / PESA 
• TESE / Micro-TESE 

Lab Techniques (Optional) Advanced

• Assisted Hatching
• Preimplantation Genetic Testing (PGT/PGD) was more expensive by the number of embryos screened.
• Embryo Glue, IMSI, PICSI - may add to the cost. 

Freezing & Storage Costs

• Additional charges may be added to the overall bill by the costs of embryo freezing (cryopreservation) and the cost of storage.

Number of Cycles Required

• The first cycle may not result in success.
• Large numbers of couples need 2 3 cycles and this increases the cost.

Additional Expenses

• Stay in hospital (complicated).
• Travel & accommodation (couples traveling to metro cities).
• Optimization treatment of lifestyle/health (thyroid, diabetes, weight management) prior to ICSI.

IVF with ICSI treatment in India

What is IVF with ICSI?

• IVF (In Vitro Fertilization): Eggs are removed off the ovaries of the woman, and combined with sperm in a lab tube, where fertilization occurs naturally.
• ICSI (Intracytoplasmic Sperm Injection): This is a type of IVF where one sperm is microinjected directly into the egg.
• Combined with ICSI, IVF will also overcome male factor infertility and minimize the chances of fertilization failure.

What conditions do we recommend IVF with ICSI?

IVF+ICSI is recommended by the doctors in cases of:

• Acute infertility in males (low sperm count, low sperm motility, abnormal sperm morphology).
• Azoospermia (None in semen; removed surgically by TESA, PESA, TESE).
• Past IVF failures (poor/no fertilization).
• Low motility frozen sperm samples.
• Where other chosen techniques have failed, unexplained infertility.
• Use of donor eggs/sperm.

IVF with ICSI Procedure:

Ovarian Stimulation

• Woman is diagnosed with hormone pills (FSH, hCG) to stimulate to produce several eggs.
• Followed up with ultrasound and blood analysis.

Egg Retrieval (Ovum Pick-Up)

• Oocytes that were harvested under light anaesthesia and with the assistance of ultrasound.

Sperm Collection

• New semen sample or sperm collected surgically in the case of azoospermia.

ICSI Fertilization

• A micropipette is used to hold each egg.

• One healthy sperm is microinjected into the egg.

Embryo Development

• The test is positive in 1820 hours.

• The embryos are cultivated in the laboratory 3-5 days.

Embryo Transfer

• The embryo with the best quality is transferred into the uterus of the woman.

Luteal Phase Support

• Progesterone pills or injections are used to promote the implantation process.

Pregnancy Test

• The pregnancy is confirmed by a blood test of 2-hCG after about 14 days.

Factors Affecting Affordable ICSI treatment packages

Factors affecting affordable ICSI treatment packages in India:

• Clinic Location & Hospital Type
• Doctor’s Expertise & Success Rate
• Ovarian Stimulation Medication Cost
• Sperm Retrieval Method
• Add-On Advanced Lab Procedures
• Embryo Freezing & Storage
• Number of Cycles

ICSI fertility treatment in India with GetWellGo

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for ICSI fertility treatment.
• Expert doctor with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food