89281 Assisted oocyte fertilization, microtechnique; greater than 10 oocytes

Name of the Procedure:

Assisted Oocyte Fertilization, Microtechnique; Greater than 10 Oocytes
Common name(s): In Vitro Fertilization (IVF) with Intracytoplasmic Sperm Injection (ICSI), Microscale Assisted Fertilization.

Summary

This procedure involves fertilizing a woman's eggs outside of her body using advanced microscopic techniques. More than 10 eggs are collected, injected with sperm, and then monitored for successful fertilization before being transferred back into the woman's uterus.

Purpose

Assisted oocyte fertilization addresses infertility issues. The aim is to increase the chances of pregnancy by manually combining eggs and sperm outside the body and ensuring successful fertilization.

Indications

• Couples experiencing unexplained infertility
• Male factor infertility (low sperm count or poor sperm motility)
• Failed previous in vitro fertilization attempts
• Women with blocked or damaged fallopian tubes

Preparation

• Hormone injections to stimulate egg production
• Blood tests and ultrasounds to monitor ovulation
• Abstain from certain medications and alcohol as advised by the doctor
• Ensure a full male partner’s sperm analysis

Procedure Description

1. Ovarian Stimulation: Hormonal injections are given to stimulate the ovaries to produce multiple eggs.
2. Egg Retrieval: Eggs are collected from the ovaries using a fine needle under ultrasound guidance.
3. Sperm Collection: A sperm sample is collected from the male partner or a donor.
4. Fertilization: Each egg is injected with a single sperm using a fine glass needle under a microscope (ICSI).
5. Incubation: The fertilized eggs (embryos) are monitored for a few days before transfer.
6. Embryo Transfer: Selected embryos are transferred into the woman’s uterus using a thin catheter.

Duration

The egg retrieval process takes about 20-30 minutes. Fertilization and embryo monitoring span over 3-5 days.

Setting

• Fertility clinic or specialized reproductive medicine center

Personnel

• Reproductive endocrinologist
• Embryologist
• Anesthesiologist (during egg retrieval)
• Nursing staff

Risks and Complications

• Mild to moderate pain or cramping after egg retrieval
• Ovarian hyperstimulation syndrome (OHSS)
• Risk of multiple pregnancies
• Ectopic pregnancy
• Infection or bleeding

Benefits

• Increased chances of conception and pregnancy for infertile couples
• Opportunity to screen for genetic disorders before implantation

Recovery

• Rest for the first 24 hours after egg retrieval
• Light activities can resume after 1-2 days
• Complete instructions on medication and care post-procedure
• Regular follow-up appointments to monitor pregnancy progress

Alternatives

• Intrauterine insemination (IUI)
• Natural conception methods
• Adoption
• Pros: Less invasive; lower cost
• Cons: Lower success rates compared to IVF/ICSI

Patient Experience

During the procedure, patients may experience mild discomfort and cramping, particularly after egg retrieval. Pain management strategies and comfort measures, such as prescribed pain medications and rest, ensure patient comfort.