When a couple is unable to conceive naturally, many consider artificial insemination as a way to finally become pregnant. Alongside in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) is one of the most successful treatments in reproductive medicine.
This article explains how the method works and who it is suitable for. The doctors listed here are specialists in their field and look forward to hearing from you.
For many couples who are unable to conceive naturally, artificial insemination is the only way to have a baby. Alongside in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) is one of the most promising methods in reproductive medicine.
In this procedure, doctors inject a single sperm directly into the egg before the embryos are transferred to the uterus. Doctors often combine this procedure with hormone therapy to improve the chances of success.
ICSI: Fertilization of the egg by injecting a sperm cell © koya979 / Fotolia
Your treating physician will thoroughly prepare you for the upcoming treatment. Before treatment begins, you must submit a request to your health insurance provider describing the necessity of artificial insemination.
In many cases, the insurance provider covers not just 50 percent but 100 percent of the treatment costs. Statutory health insurance plans do not cover more than three rounds of artificial insemination.
Doctors often combine intracytoplasmic sperm injection with hormone therapy to stimulate the maturation of multiple follicles. The doctor retrieves the eggs as soon as the follicles are large enough. During the follicular aspiration procedure, all follicles are aspirated.
It is also possible to retrieve multiple eggs. The laboratory can freeze any remaining fertilized eggs for a later attempt (cryopreservation). Health insurance plans do not cover the costs of cryopreservation.
The success of the treatment depends on the quality of the egg and the sperm. For this reason, the ejaculate is processed before sperm injection.
To select motile sperm, experts also perform a procedure known as a “swim-out.” A blood test can also determine whether the man has a genetic defect.
Furthermore, the man’s vas deferens may be blocked, meaning no sperm are present in the ejaculate. It is also possible that the man does not produce sperm in his testicles (azoospermia). In this case, the doctor may attempt to retrieve sperm from the testicles.
Unlike with IVF, doctors select a single egg and a single sperm for fertilization during ICSI. Fertilization takes place under a microscope to inject the sperm into the nucleus of the egg. Your treating doctor or biologist will repeat the process several times to create multiple embryos. These are then placed in an incubator for about 18 hours.
Afterward, the biologist checks which eggs have actually been fertilized. If fertilization was successful, the eggs begin to divide. After 24 hours, a 4-cell embryo should be present, and after 72 hours, an 8-cell embryo.
After about 72 hours, the doctor inserts the fertilized egg into the uterus using a catheter. There, the embryo will ideally continue to develop. 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 wish to have children but are unable to conceive naturally. This is especially true when the cause lies with the man. Statistically, male infertility accounts for 40 percent of cases of infertility in couples.
A prerequisite for the treatment is that the woman is fertile. ICSI is also possible even if the woman has limited fertility, as long as doctors can retrieve eggs.
ICSI is recommended if:
Only frozen sperm is available (following cancer treatment) or if sperm production is impaired. In such cases, doctors can retrieve sperm directly from the testicles.
The success rate of ICSI is over 40%. However, it depends significantly 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 a pregnancy occurs. That is why it is worth freezing the fertilized eggs to save a treatment step.
After a successful implantation, patience is key. After about two weeks, the doctor will check to see if you’re pregnant. This is done with a blood test. You’ll have to wait another one to two weeks before you see the first ultrasound image. Only then will the gestational sac be visible in the uterus.
Finally pregnant! The fertility treatment was successful @ pressmaster /AdobeStock
The good news is that statutory health insurance plans cover the treatment. However, couples considering intracytoplasmic sperm injection (ICSI) must be married. Most health insurance plans cover 100 percent of the cost of counseling sessions and preliminary examinations.
For the actual treatment, insurance plans provide a subsidy. The amount of your out-of-pocket cost depends on the scope of the therapy.
Statutory health insurance plans do not cover more than three fertilization attempts. You must then pay for the fourth treatment yourself (unless a pregnancy occurs).
The criteria for a subsidy from the health insurance provider 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 birth defects or medical conditions, which can occur even in a normal pregnancy. Nevertheless, there are now many couples who have fulfilled their dream of having a healthy baby.
Intracytoplasmic sperm injection (ICSI) is particularly suitable when natural conception is not possible. Although the treatment is somewhat complex, it significantly increases the chances of having a baby. Due to its low risks and the cost coverage provided by health insurance companies, ICSI is a promising treatment in reproductive medicine.
Every physician listed in the Leading Medicine Guide has attained the highest level of training and certification within their respective medical specialty society. Furthermore, we contacted this physician based, among other factors, on their case volume (surgeries, treatments, and therapies), which we determined by cross-referencing various publicly available sources. Following discussions with the selected physicians and the directors of the medical facilities, as well as a subsequent internal review, they were admitted to the Leading Medicine Guide.
The quality assurance of the Leading Medicine Guide is further ensured by 8 admission criteria. Each member must meet at least 6 of them:
