ICSI – Artificial insemination in Switzerland

• What is ICSI?
• Indication
• ICSI and In-Vitro
• Prodedure of ICSI
• Requirements
• Success rates

What is ICSI?

Intracytoplasmic sperm injection (ICSI) involves inserting an individual sperm directly into the egg cell retrieved from the woman. This form of artificial insemination takes place in a laboratory and is carried out in particular if the man has fertility issues.

Indication for ICSI?

ICSI treatments are carried out if the man’s sperm demonstrates reduced quality or limited mobility, or if there is a limited number of sperm available.

Difference between in vitro fertilisation and ICSI

Conventional in vitro fertilisation (IVF) involves placing the egg cell together with tens of thousands of sperm cells in a test tube. If the sperm quality of the man is insufficient, or if not enough sperm cells are produced, a conventional IVF procedure does not have a good chance of being successful.

However, this is not the case with intracytoplasmic sperm injection (ICSI): the advantage of this treatment method is that it only requires a single sperm cell. The egg cell is directly fertilised by experienced biologists with a specially selected, quick and optically perfect sperm.

ICSI procedure

How is ICSI done? An ICSI treatment is similar to conventional IVF:

1. After a comprehensive consultation, your Hirslanden doctor will test the man’s sperm quality and organise hormonal treatment for the woman. This treatment prevents premature ovulation and stimulates the ovaries to mature several ovarian follicles at the same time.
2. At regular check-ups over the next two weeks, your doctor will examine the maturity of the egg cells and decide whether it is time to trigger ovulation. If the egg cells are ready, the doctor will remove them from the ovaries. This outpatient procedure is performed at your Hirslanden doctor’s medical practice and you will be able to leave the hospital on the same day. On the day of the procedure, the man provides a semen sample. The most suitable sperm cells are chosen and prepared using various methods, such as physiological sperm selection.
3. The next step is the actual intracytoplasmic sperm injection (ICSI): the sperm cell is transferred directly into the cell fluid of the egg cell. The fertilised egg cells are then observed over a period of three to five days as they develop into embryos.
4. Following this, your Hirslanden doctor will transfer one or two of the embryos into the woman’s womb (embryo transfer). If some of the other embryos have also developed well, on request they can be frozen in liquid nitrogen and stored at the laboratory, so that they will be available if further treatments are necessary or desired in the future.
5. In special situations, separate types of treatment such as pICSI (physiological ICSI, in which the optimum sperm present themselves), IMSI (particularly detailed analysis of the sperm under a special microscope) or co-treatment with calcium ionophore are used in place of the normal ICSI treatment.
   

Requirements

To be able to carry out IVF or ICSI treatment, the following requirements must be fulfilled:

• Basic data exists (hormone examination of the woman, ultrasound, spermiogram)
• Age of the woman maximum between 43-44 years, age of the man maximum 63-65 years
• Negative HIV, hepatitis B/C, syphilis status of both partners
• Proven immunity to rubella and chickenpox
• Stable partnership (the couple does not have to be married)

The selection of embryos by sex or external characteristics is prohibited by law in Switzerland.

Success Rates of ICSI

The probability of success depends primarily on the age of the woman and her individual ovarian reserve. From the age of 35, the chances of success start to decrease and are halved by the age of 40.

During the diagnostic phase, various tests are carried out, the findings of which permit a relatively precise assessment of your personal situation. Your attending doctor will inform you about the chances of you having children before you make the decision whether to undergo ICSI.

Based on these results, your doctor can give you a personal and relatively precise assessment of the chances of success of fulfilling your desire to have children.