This is the story of my niece. Sometimes it is hard to digest that this baby I held in my arms, marveling at her gorgeous smiles, is now a mom of one, and going through this current phase.
She’s smart, beautiful, did well in academics, is fun to be with, has a wonderful career and a life partner. Almost perfect life.
Three years ago, she gave birth to her precious baby girl. She was 32 at that time and of course, had people constantly telling her she had delayed getting pregnant and was likely to face complications. Talk about blessings, eh? I had my share of it—I was 34 when my son was born.
And as Fate would have it, hers was not an easy pregnancy, but neither was it as bad as everyone predicted.
Now, she is 35, and is dreaming of having a second child. She’s also nervous that this may not happen. The problem is, about two years ago, her husband was in a terrible motorcycle accident, resulting in multiple fractures on both his legs. He injured his testes as well. Although everything has healed quite well now, there does seem to be a problem with the sperm count and quality.
Of course she consulted her gynecologist—one of the best in Bangalore, but given the sperm related issue, the gynec is a little concerned. After a series of tests, she suggested something called an Intra-Cytoplasmic Sperm Injection or ICSI procedure.
The gynec explained that this was just another step added to the usual IVF procedure to increase the chances of fertilization of the egg, since this is the primary concern, rather than the pregnancy itself. Of course, my niece wasn’t wholly reassured and worried about the procedure it involved. Then there was also the affordability aspect. How expensive would it be? What were the chances of success, even if they decided to take up the option? Is it okay to even consider assisted reproductive methods?
Sleepless nights of the not-so-nice kinds followed.
I am not guilty about firmly shaking her out of her worry and advising her to consider the possibilities rather than go down a spiral of worry. Stress was the last thing she needed at this time. I said, do the research, because knowledge is power. Find out what ICSI is, talk to people who have experience with the process and then make an informed decision. Yes, go ahead and pat my back.
I am glad to say she took the advice. Here’s what she learned:
What is ICSI
Okay, the good news first; there are many good hospitals offering ICSI in Bangalore, and I am sure that are equally good clinics in other metropolitan cities as well. It is a fact of life that fertility declines with age in women. This might not only impact the chances of a successful natural pregnancy but also success of assisted reproductive procedures. So, leaving it until your late 30s or early 40s to try to get pregnant is a bad idea. At 35, my niece was on the verge of this age group and it was time to act. Now.
If you are wondering how this procedure is different from in-vitro fertilization of IVF treatment, here’s the answer: In ICSI, the specialist injects a sperm directly into the egg, using a very thin needle. In IVF, the egg is first harvested, and then placed in a dish with many sperms, allowing natural fertilization to take place, under laboratory conditions.
Was it the right choice for my niece?
When researching about the procedure, she found that gynecologists often recommended ICSI for cases of low sperm count or poor quality sperm with low motility. It is also recommended for cases where IVF has failed. Her doctor, whom I consider the best gynecologist in Bangalore, explained that in her case, the IVF procedure would be followed, where the eggs would be harvested and fertilized under laboratory conditions. However, to ensure greater chances of success, ICSI would be used to inseminate the eggs. The rest of the process would be identical to IVF, with the eggs being monitored in the laboratory for fertilization.
Once the embryo stage was reached, the doctor would do a single embryo transfer or SET, where the embryo would be implanted in my niece’s uterus. She would then need to go back for regular checkups to monitor the development of the fetus.
Now, the most important question: what is the success rate?
Well, this was the next question on our minds. We were very aware that failure would be a huge disappointment and affect my niece emotionally. Her doctor explained that the success rate of ICSI in Bangalore, and apparently the rest of the world, is the same as that for the IVF procedure. Most studies have revealed that 50% to 80% of eggs get fertilized during this procedure. So, while no one can guarantee that it would be a success the first time around, multiple eggs are harvested and preserved so that more attempts can be made if the first one fails.
This was very reassuring. In fact, this seemed like a viable option to my niece, because, even in a natural pregnancy, you don’t even know if you are pregnant till you miss your periods and then a pregnancy test is not always accurate. Here, at least, some of that uncertainty was taken care of because everything was happening right before your eyes.
My niece’s experience
My niece’s experience was actually much better than she had feared. She went into it with eyes wide open, well aware that there are no guarantees in life. Yes, the first egg did not get fertilized, but a second cycle proved successful. Neither the harvesting nor the embryo implantation were too painful or debilitating. She is now in the eighth month of pregnancy and everything seems to be going well. Touch Wood. Next month this time, I am hoping to be a proud grand-aunt of two!
When I asked her how she was feeling right now, she said she would certainly recommend ICSI, and Bangalore has some wonderful facilities. For those planning a second baby, or even a first, exploring their options rather than giving up hope at the first signs of failure is the right way to go.
Well done, niece!
Did you know about ICSI, or someone who has gone through the procedure?
I wonder what their experience has been, and would love to hear it in the comments.