Risks Associated With Intracytoplasmic Sperm Injection

Intracytoplasmic sperm injection (also known as ICSI) is an assisted reproductive technology (ART). In ICSI, a mature and healthy egg is fertilized with a single sperm to optimize the chances of successful conception. Once fertilization takes place in a controlled environment (such as laboratory), the developing embryo is transferred inside the uterine cavity for growth and nourishment.

The indications for ICSI are:

• Subfertility in men i.e. low motility of sperms or low sperm count.
• Women who have damaged or blocked fallopian tubes.
• Women who are experiencing difficulty in getting pregnant due to a pelvic surgery or injury.
• Ovulation disorders.
• Premature ovarian failure.
• Uterine fibroids.
• Infertility (unexplained and non-responsive to traditional therapies)
• Couples with certain genetic disorders that may be transferred to the offspring in case of a pregnancy

Steps Involved In Intracytoplasmic Sperm Injection

• First step involves monitoring and development of wholesome eggs in the ovary. For Intracytoplasmic Sperm Injectionmore than one egg is required because chances are fair that some eggs might not develop or won’t be suitable for the fertilization. For optimal development of eggs, certain fertilization medicines are advised to the mother. Throughout this time period, ovaries are monitored via periodic transvaginal ultrasounds along with examination of hormonal levels through the blood tests.
• Once eggs are produced, a minor procedure is performed to remove the mature eggs for fertilization via needle introduced through the pelvic cavity.
• The semen sample is obtained (either from the male partner or a donor). With the help of a highly delicate needle, a single sperm is selected, immobilized and injected in the cytoplasm of the mature egg.
• After three to five days of egg fertilization, the embryo is transferred inside the uterus via small catheter or tube. Generally the procedure is painless; however, some women may experience abdominal cramps. Implantation of embryo generally takes place after 6 to 10 days of egg fertilization.

Side Effects Of Intracytoplasmic Sperm Injection

You can resume your daily activities in about a day after the procedure, but it is recommended to take extra caution. Some side effects commonly experienced after the procedure are:

• Mild cramping and bloating
• Fluid discharge which can be clear or with tint of blood
• Tenderness in breasts
• Constipation

However some side effects can be very serious and if any is experienced, immediately refer to your doctor. Symptoms include:

• Severe vaginal bleeding
• Blood in urine
• Pain in pelvis
• Body temperature above 38C or 100.5F

Risks Associated With Intracytoplasmic Sperm Injection

The fertility medicines given during the treatment have certain side effects including:

• Mood swings
• Pain in abdomen
• Hot flashes
• Headache
• Bloating

These medications can rarely cause ovarian hyper-stimulation syndrome (OHSS), which may present with symptoms like pain and feeling of being bloated. In some cases, severe symptoms may occur, such as:

• Shortness of breath
• Decreased urinary output
• Faintness
• Nausea and vomiting
• Weight gain within days

Speak to your doctor immediately if you are experiencing unpleasant symptoms after the procedure.

Additional Risks

• Retrieval of eggs can cause infection, bleeding and damage to the bladder or bowel.
• Risk of having multiple pregnancies is fairly high. Multiple pregnancies can lead to premature delivery and low birth weight.
• If ICSI fails, couple may experience depression, stress and other emotional issues.
• The cost of ICSI is fairly high (one cycle can cost up to $17,000 or more) and this cost may not be covered by your insurance plan.

How Successful Is ICSI Method?

The rate of success depends upon various factors including, age of mother, cause of infertility, lifestyle of couple and their reproductive history. One must understand that the rate of pregnancy and rate of live birth are not the same.

What If The Women Is Not Able To Produce Healthy Eggs Or Her Husband Is Infertile?

In such cases there are options to obtain donor eggs, sperms and embryos. But before choosing this option, the couple must know the legal rules regarding the donation of gamete.

How Many Embryos Can Be Created Or Transferred?

It depends upon how many eggs are obtained and the age of mother. As mother ages, multiple eggs may get implanted to increase the success rate. However, transferring multiple eggs also increases the risk of multiple pregnancies.

References:

1. http://americanpregnancy.org/infertility/intracytoplasmic-sperm-injection/

2. Klement, A. H., Koren-Morag, N., Itsykson, P., & Berkovitz, A. (2013). Intracytoplasmic morphologically selected sperm injection versus intracytoplasmic sperm injection: a step toward a clinical algorithm. Fertility and sterility, 99(5), 1290-1293.

3. Johnson, L. N., Sasson, I. E., Sammel, M. D., & Dokras, A. (2013). Does intracytoplasmic sperm injection improve the fertilization rate and decrease the total fertilization failure rate in couples with well-defined unexplained infertility? A systematic review and meta-analysis. Fertility and sterility, 100(3), 704-711.