From the very beginning days of IVF, it was a method to treat infertility in female participants. With the development of technology over time, IVF treatments now, also includes methods to address and treat male factor infertility.
To understand how male factor infertility occurs and how to treat it, one has to know how does fertilization of egg happens. During the process of fertilization, the fastest sperm cell reaches the egg first. This sperm cell then proceeds penetrating the egg cell and dies while penetrating the egg membrane. During the process of trying to penetrate the egg, the sperm cell helped loosen the oocyte membrane. Soon after the membrane is broken down enough, one of the approaching sperm cell (contrary to popular belief, not the fastest) can penetrate the egg and fertilize it. The hole, through which the sperm cell entered the egg membrane, closes right after fertilization.
ICSI is a procedure which can help address male infertility during the IVF procedure, but which kind of male infertility in particular can be addressed with ICSI? It is important to note that for the procedure to be carried out there is a need of only one sperm cell for the egg cell to be fertilized. Hence most fertility experts will advise ICSI when:
While ICSI seems to be an ideal method, its important to note that it is a method that sidesteps the natural process where millions of sperms compete and a best of the one is selected. Due to this it is not recommended to use ICSI, unless one of the above mentioned conditions is occurring in the patient/ patients.
The process of ICSI sometimes, actually rarely comes to a situation when there are no eggs available or the eggs get damaged during the process of injection, which makes the egg unfit for further procedure. This case happens statistically less than 10 percent of the time. The problem in both these cases is the quality of the egg and not that of the sperm and hence the risk posed is higher from female factor than male. Statistically ICSI has a very low rate of failure, with less than 1-3 percent of failure rates.
Based on the fertilization process described above, it is understood that for fertilization to occur, male sperm should have a certain amount of active sperm cells (motile) or else none of them will make the journey through the vaginal cavity all the way to the egg cell. But what can be done if there aren’t enough active sperm cells or if the sperms cells are not motile enough? ICSI is a type of technology that can help men through the IVF process. A more detailed list of when is ICSI needed is in next section.
ICSI or «Intra Cytoplasmic Sperm Injection», also known as intracellular sperm injection, is one of the auxiliary stages of in vitro fertilization. The procedure consists of an embryologist choosing only the best, most active sperm cell (as embryologists like to refer to it «the most beautiful») from the patient’s collected sperm. The sperm cell is then immobilized with a special tiny needle under an electron microscope. This immobilized sperm cell is then helped into the egg by injecting it directly into the egg cell. With this method, ONLY ONE sperm cell is necessary to complete the fertilization process instead hundreds or millions, which is the natural process.
I sit back and watch my little 6-month-old wonder, peacefully burbling in the cradle. I have an opportunity to look back at every memory from the beginning.
I didn’t think about having children at a young age. I wanted to «live for myself» and more importantly I wanted to pursue a career. When I turned 34, my husband and I decided, «That the time was right for us ». I stopped birth control and the first half year went without any success but we were not too worried. It was after that, we started to worry. We tried a lot of different things, which included changing our diets completely, Medical examinations in various clinics and I even tried handstands after sex to improve the probability of egg getting fertilized. We could not get any proper reasoning from the Doctors, who were at complete loss. We were exhausted, disappointed and upset. We even had four IVF treatments in two different clinics over the period of six months, but only one pregnancy which ended in a miscarriage in the early stage.
I was so overwhelmed that I almost gave up. There were arguments with my husband; as he had wanted a baby much earlier and I was the one delaying. He had now started to nag me—it was my fault that we ran out of time. All in all, I have no idea how everything was going to work out and what was going to happen it happened so unexpectedly.
During the summer, I decided to go to my mother’s home country. An old friend was there with her husband playing with their two toddlers in the playground. We had known each other since we were kids. Our parents were close and we were virtually neighbours both in the city as well as in our country homes. We grew up together but had lost touch since I moved away. We may not have been best friends, but we most certainly weren’t strangers. On the following evening I was invited over to dinner and I obliged. Once there, over the dinner table the discussion began and before I realized, I was already telling her about my situation in detail. At this point she confided in me that her twins were actually result from IVF treatment. She revealed to me her own struggles while trying to get pregnant and she advised me to meet her doctor while I was still here.
I knew that I has nothing to loose and hence went for the first visit. My fertility specialist, as my friend as suggested, was Anna Morozova. She has an aura of comfort and ease about her and I immediately felt calm and comfortable with her. There was no typical doctor gibberish, that I had experienced in my previous consultations at other clinics. For example, a very common phrase that I kept hearing was «if you don’t understand anything, just listen carefully and do what I say». I found discussing my issue with Anna was very easy and natural and we were on the same page from the beginning and discussed everything. One of her key phrases that I still remember was: «Unexplained infertility doesn’t mean that there isn’t a reason. Its just that we just haven’t found it yet and we will look for it until we will find it». She was true to her word and the procedure included 11 cells and 8 embryos, 5 of them had very good morphology. From then on, everything was simple — we selected the embryo’s sexual gender and I got pregnant after the first attempt! Now, here I am: a 39-year-old «young mommy» sitting in the kitchen, cooking dinner, and looking after my baby, Anya.
Anna Vladislavovna Morozova, there are no words that can express my gratitude how grateful I am. A word of advice to young girls: do not waste time. Time is what you may not have enough of.
My infertility story is one of the most common ones. From the age of 15 every month I had horrible pain; doctor’s advice to me was «everything will be fine after pregnancy» and that I should have a baby as soon as possible.
At 23, I had a medical examination for a kidney stone and the examination revealed that I had two endometriotic cysts: the first one was 7 cm and the second 8 cm. In 2005, I had to have an abdominal surgery. I always wanted to have a couple of children and after the surgery, I was worried that it had affected my chances to have a full family. At this point my doctor ensured me that everything was ok and the surgery had in no way interfered with my ability to get pregnant and have children in future.
Believing the doctors at the time, I put this worry behind me and forgot about it. In 2007 I got married and both of us wanted a baby. I decided not to take any contraceptive and we had a regular sexual life, but at the end of every cycle I was still not pregnant. It was already 2011 when we started to worry and approached doctors for medical advice. The process was exhaustive and the reason for infertility was diagnosed only in 2013, when I came to GMS where I was suggested to have Laparoscopy. I had laparoscopy/hysteroscopy, which revealed a tubal obstruction and endometriosis diagnosis. I had to have an adhesiotomy for my fallopian tubes and a tubal cauterization for the endometriosis. After that, I decided to undergo an IVF procedure and I was very lucky that I had Anna Morozova as my doctor. She was both an amazing expert and a great source of strength during my procedure. The first two weeks were a bit fuzzy, but I took a beta-HCG test, which revealed that I was pregnant! Wow! On the first try! On the twenty-first day after IVF procedure, there was one embryo (2 were transferred) and on the twenty-eighth day we heard a heartbeat on the ultrasound... Nine months passed and I had been taking care of my bump like crazy. After a Caesarean operation, I had my little boy, Vasily. Now he’s 15 months old.
I owe a big thanks to the team of doctors who helped me — especially Anna Vladislavovna Morozova! Without them, I do not know how much struggle I would have had to achieve this happiness.
Long time ago, when I was 18, I got pregnant but I didn’t know about it. Those were days when I was a carefree girl who didn’t really pay attention to menstrual cycles; if my periods were delayed, I didn’t think much about it. Now it’s hard to believe I was like that, but it’s true.
I remember looking in my bathroom mirror and thinking, «I’ve put on weight. Maybe I should start running every morning to get back to normal». I did not even realise that I was pregnant when my breast got bigger and the only thought that occurred was that my boyfriend would be pleased. I realized that I was pregnant only when a accidental fall led me to bleed and a resulting miscarriage.
The accident was a life changer and something in me changed fundamentally. In a few years time I was looking to get pregnant but was unsuccessful. This worried me and I started seeing doctors who told me everything was ok. My second husband though was not happy and we decided to see a fertility expert. I finally was diagnosed with secondary infertility. I had pelvic adhesions, and polycystic ovary syndrome in the left ovary. I had to undergo dilation and curettage because of some bleeding, which revealed a polyp on the cervix. I had heard of IVF and even read about it before on the Internet, but I didn’t have enough money to have that kind of treatment.
Through a stroke of luck, my health insurance started to cover IVF. I had a bunch of tests, went through all the necessary red tapes, and received a treatment plan. The first procedure did not reveal any results. I was exhausted after all the treatments and was mentally exhausted. I decided to take a break for 2 months and then try again. This time I has a favourable result and I for pregnant. I’m so thankful to Anna Morozova, my fertility specialist. I will be thankful to her for the rest of my life! When I saw those two lines on my pregnancy test, I went crazy with joy: I cried and laughed at the same time. After 9 months, as planned, I gave to birth a baby girl. I joked that she was a little warrior like her father: she weighed 4800 g and was 52 cm long. I had a difficult delivery, which is understandable because it was my first full-term pregnancy at the age of 37. Now our little girl is already two years old. Well, that’s how I finally became a mother 20 years after my first pregnancy. A word of advice to the young, «Count your blessings: keep your pregnancy and don’t get an abortion!»