Assisted hatching and intracytoplasmic sperm injection (ICSI) are micromanipulation techniques sometimes used during IVF procedures.
Assisted hatching is a very delicate procedure, requiring immense skill. It is performed using micromanipulation techniques, under a microscope, during the fourth day of embryo development.
The embryo is first placed in a petrie dish containing culture solution. A special pipette is then used to hold the embryo in place. The embryologist takes a hollow needle that contains an acidic solution and places it next to the zona pellicuda. A tiny bit of this acidic solution is released from the needle so that it comes into contact with the zona pellicuda. This acidic solution begins to slowly digest the protective layering, creating a small hole. The embryo is then washed in a special solution and placed back inside an incubator until embryo transfer can take place.
Assisted hatching techniques aren't suitable for every couple. Instead, the procedure is typically recommended for:
Unfortunately, there are some risks associated with assisted hatching procedures. In particular, assisted hatching procedures do seem to increase the likelihood that you will have identical twins (also known as monozygotic twins). This is because the micromanipulation technique used to break through the zona pellicuda can sometimes cause the embryo to split into two identical halves.
There is also an increased risk of:
The procedure can sometimes also cause complications for the mother, including:
These side effects are the result of the steroids and antibiotics that you must take during the transfer procedure. Because the protective layer surrounding the embryo has been compromised, it is essential that you take medications to slow your immune system down and to prevent infection of the embryo.
Many couples elect to pursue assisted hatching during their IVF procedures. This is because the technique is associated with a number of benefits including:
Unfortunately, assisted hatching does have its drawbacks.
Specifically, assisted hatching is:
ICSI is a procedure utilized to treat moderate to severe male factor infertility. Before a man's sperm can fertilize a woman's egg, the head of the sperm has to attach to the outside of the egg. Then it pushes through the outer layer of the egg to the inside of the egg (cytoplasm). Sometimes the sperm are not able to penetrate the outer layer of the egg. A procedure called intracytoplasmic sperm injection (ICSI) can help by injecting the sperm directly into the egg.
How does ICSI work?
In traditional IVF, the sperm are mixed with the woman's egg in a laboratory. If ICSI is needed, a small needle is used to inject a sperm into the center of the egg. The fertilized egg grows in a laboratory for one to five days, then it is placed in the woman's uterus (womb).
Why would I need ICSI?
ICSI helps to overcome a man's fertility problems, for instance:
ICSI can also be used when the use of traditional IVF has not produced fertilization, regardless of the condition of the sperm.
How is sperm retrieved for use in ICSI?
For men who have low sperm count and sperm with low mobility, the sperm may be collected through normal ejaculation. If the man has had a vasectomy, the microsurgical vasectomy reversal is the most cost-effective first choice option for fulfilling the desire to have children.
Sperm aspiration refers to the group of procedures used to obtain viable sperm from the male reproductive tract. Needle aspiration or microsurgical sperm retrieval, are good alternatives when a competent microsurgical vasectomy reversal has failed, or when the man is opposed to surgery. Needle aspiration allows physicians to easily and quickly obtain adequate numbers of sperm for the ICSI procedure. A tiny needle is used to extract sperm directly from the testis. Needle aspiration is a simple procedure performed under sedation with minimal discomfort; however there is potential pain and swelling afterwards. The sperm obtained from testis is only appropriate for ICSI procedures when testicular sperm is not able to penetrate an egg by itself.