If the desire to have children remains unfulfilled, many couples consider artificial insemination in order to finally become pregnant. Alongside in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) is one of the most successful therapies in reproductive medicine.
This article shows how the method works and for whom it is suitable. Our doctors listed here are specialists in their field and look forward to hearing from you.
For many couples with an unfulfilled desire to have children, artificial insemination is the only way to have a baby. In addition to in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) is one of the most promising methods of reproductive medicine.
In this method, doctors inject the sperm directly into the egg before the embryos enter the uterus. Doctors often combine the therapy with hormone treatment to improve the chances of success.
ICSI: Fertilization of the egg cell by injection with a sperm cell © koya979 / Fotolia
Your doctor will prepare you thoroughly for the upcoming treatment. Before the treatment begins, you must submit an application to your health insurance provider describing the need for artificial insemination.
In many cases, the health insurance fund will not only cover 50 percent of the treatment, but 100 percent. More than three artificial inseminations are not covered by statutory health insurance.
Doctors often combine intracytoplasmic sperm injection with hormone treatment to allow several follicles to mature. The doctor removes the eggs as soon as the follicles are large enough. As part of the follicular puncture, all follicles are punctured.
Several eggs can also be retrieved. The laboratory can freeze the remaining fertilized eggs for a later attempt (cryopreservation). The costs of cryopreservation are not covered by health insurance.
The quality of the egg and sperm cells is crucial to the success of the treatment. This is why the ejaculate is prepared before the sperm injection.
In order to select sperm with good motility, experts also carry out a so-called swim-out. A blood test can also provide information on whether the man suffers from a genetic defect or not.
Furthermore, the man's vas deferens may be blocked, meaning that no sperm can be found in the ejaculate. It is also possible that the man does not produce any sperm cells in the testicles (azoospermia). In this case, the doctor can try to extract the sperm cells from the testicles.
In contrast to IVF, doctors select a single egg and sperm cell for fertilization in ICSI. Fertilization takes place under a microscope in order to transfer the sperm cell into the nucleus of the egg cell. Your attending doctor/biologist will repeat the process several times to create several embryos. These are then placed in the incubator for around 18 hours.
The biologist then checks which eggs have actually been fertilized. If fertilization was successful, the egg cells begin to divide. After 24 hours there should be a 4-cell and after 72 hours an 8-cell.
After around 72 hours, the doctor inserts the fertilized egg into the uterus using a catheter. The embryo continues to develop there at best. To increase the chances of a successful pregnancy, two or three eggs are usually implanted at the same time.
Intracytoplasmic sperm injection is suitable for couples who are unable to conceive naturally. Especially if the cause lies with the man. Statistically speaking, 40 percent of infertility in a couple is caused by the man's inability to conceive.
The prerequisite for treatment is that the woman is fertile. ICSI is also possible if the woman's fertility is impaired, as long as doctors are able to retrieve eggs.
ICSI makes sense if:
Only frozen sperm are available (after a tumor) or if sperm production is restricted. Doctors can then obtain sperm directly from the testicles.
The chances of success of ICSI are over 40%. However, they are largely dependent on the woman's age. The treatment is complex, which is why doctors cannot guarantee success. Couples usually have to repeat the procedure once or twice before pregnancy occurs. It is therefore worth freezing the fertilized eggs in order to save one treatment step.
Patience is required after successful implantation. After around two weeks, the doctor will check whether you are pregnant. This is done with a blood test. You will have to wait another one to two weeks before you see the first ultrasound image. Only then will you be able to see the amniotic cavity in the uterus.
Pregnant at last! The fertility treatment was successful @ pressmaster /AdobeStock
The good news is that statutory health insurance companies support the treatment. However, couples considering intracytoplasmic sperm injection must be married. Consultations and preliminary examinations are covered 100 percent by most health insurance companies.
The insurance companies provide a subsidy for the actual treatment. The amount you pay depends on the extent of the treatment.
Statutory health insurance companies will not covermore than three fertilization treatments. You will then have to pay for the fourth treatment yourself (unless a pregnancy occurs).
The criteria for a subsidy from the health insurance company are
Pregnancy usually proceeds normally after artificial insemination. However, the risk of miscarriage or multiple births is slightly higher.
There is also a risk of malformations or illnesses, which can also occur during a normal pregnancy. Nevertheless, there are now many couples who have fulfilled their dream of having a healthy baby.
Intracytoplasmic sperm injection is particularly suitable if natural fertilization does not work. Although the treatment is somewhat time-consuming, the chance of having a baby is increased many times over. ICSI is a promising treatment in reproductive medicine due to the low risks and the fact that health insurance companies cover the costs.
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