Conceiving with ICSI

ICSI stands for intracytoplasmic sperm injection. This fertility treatment involves injecting a single sperm directly into an egg's cytoplasm (the inner part of the egg).

Both ICSI and IVF are assisted reproductive technologies used to help fertilise an egg outside the body. The key difference lies in how fertilisation happens. In IVF, eggs and sperm are simply mixed together in a dish, allowing fertilisation to occur naturally. ICSI takes a more direct approach: a single sperm is carefully injected into an egg using a microscopic needle.

ICSI has become the most common method of assisted reproduction in Switzerland. It is even performed more frequently than conventional IVF. Precise figures on the frequency of ICSI treatments are difficult to find, as not all clinics and centers report their data centrally.

Experts estimate that ICSI is used in about 70-80% of IVF cycles.

ICSI treatment can be useful in various situations, especially in the following cases:

• Male infertility: If the man has a low sperm count (oligospermia), poor sperm motility (asthenozoospermia), abnormal sperm morphology (teratozoospermia), or a combination of these factors (OAT syndrome), ICSI can increase the chance of pregnancy. If there are no sperm in the ejaculate (azoospermia), they can be extracted from the testicles through a minor surgical procedure (TESE).
• Impaired egg quality: If the eggs have a thickened outer shell (zona pellucida), sperm may not be able to penetrate on their own. In this case, ICSI can help.
• After unsuccessful IVF attempts: If several IVF attempts have been unsuccessful, ICSI may be an alternative.
• Use of cryopreserved eggs: When using frozen eggs, ICSI is the method of choice, as the outer shell of the egg has been removed.
• Polar body diagnosis (PBD): If a genetic examination of the egg (polar body diagnosis) is to be carried out, ICSI is necessary.

The success rates of ICSI per treatment cycle are on average 30-40%, depending on various factors such as the woman's age, the cause of infertility, the number of fertilised eggs and the quality of the embryos.

The costs for ICSI treatment in Switzerland are generally between CHF 7,000 and CHF 9,000 per cycle, depending on the medication required and additional services (e.g., PGD or assisted hatching). At Cada, the costs for ICSI, including medication, are between CHF 7,100 and CHF 7,800.

Since we only transfer one embryo at Cada (Single Embryo Transfer, SET), the risk of a multiple pregnancy is significantly reduced and is about 1%.

The risk of chromosomal abnormalities in the child is not fundamentally increased with ICSI. However, there are some studies that suggest that the risk of certain rare genetic defects may be minimally increased.

Yes, medication is usually required before ICSI treatment. However, an exception is IVF or ICSI in the natural cycle, where no hormones are used.

The aim of hormonal stimulation is to stimulate the growth of several egg follicles in the ovaries in order to obtain several mature eggs for fertilisation. Various medications are used for this purpose, which contain hormones or influence their production:

• GnRH analogues suppress the body's own hormone production in the pituitary gland to prevent premature ovulation.
• Gonadotropins contain hormones (follicle-stimulating hormone (FSH) and/or human menopausal gonadotropin (hMG)) that stimulate the growth of follicles in the ovaries.
• hCG (human chorionic gonadotropin) is used for egg maturation when the follicles have reached a certain size. It is administered once as an injection.

After the embryo transfer, progesterone is used to support the implantation of the embryo in the uterine lining. It is usually administered in the form of vaginal tablets or capsules.

The number of ICSI attempts needed varies greatly from person to person and depends on several factors, such as the woman's age, the cause of infertility, and the quality of the embryos. Some women become pregnant on the first attempt, while others need several attempts.

An ICSI treatment takes about 4-6 weeks in total, depending on the treatment protocol and individual requirements.