Our IVF Journey

Hysteroscopy & Intracytoplasmic Sperm Injection (ICSI)

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Hysteroscopy & Intracytoplasmic Sperm Injection (ICSI)
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A Hysterocopy is a diagnostic procedure performed in our office to evaluate the uterine cavity. The procedure entails placing a speculum in the vagina; the MD will then cleanse the vagina with an antibacterial solution (betadine). Local anesthesia (1% lidocaine) is placed around the cervix. Following this, the cervix is grasped with a tenaculum and the cervix and uterus are examined with the fiber optic hysteroscope. A small amount of carbon dioxide is used to distend the uterus to allow for adequate visualization, some cramping and spotting may be encountered. During the procedure the doctor will also perform a uterine measurement, Pap smear and cervical cultures if needed.

An antibiotic, usually doxycycline lOOmg, should have been prescribed for you. Fill this prescription and start taking it the day before the hysteroscopy is scheduled. You will take the doxycycline twice a day and continue the day of the procedure and two days after the procedure. Make sure you take the doxycycline with food, as this medication may cause stomach upset on an empty stomach. Also avoid the sun while taking this medication; doxycycline may make you more sensitive to sunlight.

On the day of the procedure, make sure you have arranged for transportation home. After you have a consult with the MD, you will be pre-medicated A hour before the procedure with an oral Valium tablet to relax you and an intramuscular injection to reduce cramping. You will not be able to drive after taking this medication. You will need a family member or friend to drive you home.

AFTER YOUR HYSTEROSCOPY

1. You will have some vaginal bleeding. It may last 3-7 days. For most women it is not heavier than a regular menstrual period.

2. You may have some cramping. We recommend you take ibuprofen (Advil or Motrin) up to SOOmg every 8 hours, or naproxen (Nuprin, Naprosyn) up to SOOmg every 12 hours

3. You should maintain pelvic rest until your bleeding stops. This means no tampons, no douching, and no vaginal intercourse. Use a pad for the bleeding.

4. Do not drive on the day of the hysteroscopy. The medications you were given before the procedure will affect your driving skills.

5. Complications after the procedure are uncommon, but you should call the clinic immediately for any of the following problems:

a.   Temperature above 100.5 degrees F.

b.  Pelvic pain that does not go away with ibuprofen or naproxen

c.  Foul-smelling vaginal discharge

 

6. There are no restrictions on lifting or exercise after the hysteroscopy. Most women are able to return to work and normal activities the following day.

 

Intracytoplasmic sperm injection (ICSI) is a laboratory procedure developed to help infertile couples undergo­ing in vitro fertilization (IVF) due to male factor infertility. ICSI, a form of micromanipulation, involves the injection of a single sperm directly into the cytoplasm of a mature egg (oocyte) using a glass needle (pipette). This process increases the likelihood of fertilization when there are abnormalities in the number, quality, or function of the sperm. ICSI is generally unsuccessful when used to treat fertilization failures that are primarily due to poor egg quality.

A variety of abnormalities can cause male infertility. Sperm can be completely absent from the ejaculate (azoospermia) or present in low concentrations (oligospermia). Sperm may have poor motility (asthenosper-mia) or have an increased percentage of abnormal shapes (teratospermia). There may also be functional abnor­malities which prevent the sperm from binding to and/or fertilizing the egg.

Indications for Intracytoplasmic Sperm Injection

• Very low numbers of motile sperm.

• Severe teratospermia.

• Problems with sperm binding to and penetrating the egg.

• Antisperm antibodies thought to be the cause of infertility.

• Prior or repeated fertilization failure with standard IVF methods.

• Frozen sperm limited in number and quality.

• Obstruction of the male reproductive tract not amenable to repair. Sperm may then be obtained from the epi-didymis by a procedure called microsurgical epididymal sperm aspiration (MESA), or from the testes by tes-ticular sperm aspiration (TESA).

Fertilization occurs in 50% to 80% of injected eggs. The ICSI process may damage a small percentage of eggs. The fertilized egg may fail to divide, or the embryo may arrest at an early stage of development. Approx­imately 30% of all ICSI cycles performed in the United States in 1998 resulted in a live birth, which is compa­rable to rates seen with traditional IVF. Younger patients may achieve even more favorable results. Factors such as poor egg quality and advanced maternal age may result in lower rates of success.

ICSI does not increase the incidence of multiple gestation as compared to standard IVF. Because ICSI is a rel­atively new technique, first performed in 1992, long-term data concerning future health and fertility of children conceived with ICSI is not available. Some studies report that the incidence of a congenital malformation called hypospadias (urethra opening on underside of penis) is increased in babies conceived through ICSI. This is an area of ongoing investigation. Because some causes of male infertility are familial and are related to genetic problems, male offspring might have reproductive problems as adults. Despite these concerns, ICSI is a major advance in the treatment of severe infertility.


 

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Hi! I would like to mention that this webpage is still in it's beginning stage. This is my first time putting a website together. So please be gentle and bear with me:).
Some of the information may not be complete. I am still waiting for some records so I can add more details to the treatments and protocols I have listed. I am going to update it as our journey progresses. Check in again to see what's been happening.
 
 

Disclaimer: This Website is meant to be  a "Journal" not a "Medical Advice" site. All the information gathered here is a collection of personal documentations and memories.  I do not take responibility for it's accuracy. Nor is any of the information meant to be used for medical advice. Always consult your doctor with questions concerning your treatment.
 
 
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