Tag: icsi
Bio-mechanical Insights showing RoboICSI is superior to conventional ICSI
Positioning and pipette alignment problem
During ICSI aligning the holding pipette (HP) and injection pipette (IP) in a straight line is very important. Proper alignment is important to avoid the IP entering the oocyte in an angle relative to the HP. If this happens then it creates increased tension on the oolemma, which may lead to tearing of the oolemma. This also leads to miss-deposition of the spermatozoa into the oocyte. [2]
If both the pipettes are not in same plane the oocyte starts rotating off the holding pipette and as injection pipette passed into the oocyte, due to this, the oolemma stretches and it will be prone to rupture. [1]
A tension gets created if a bevel tip of holding pipette is not in parallel to bottom surface of the Petri dish, hence the holding of the oocyte becomes difficult, as the base of the dish avoid the oocyte from meeting squarely on to the holding pipette. [1]
RoboICSI: RoboICSI alignment can be controlled with few touch point actions and getting the RoboICSI Holder in plane with the IP is very easy. And during the alignment of RoboICSI Holder there is no fear of the consumable getting damaged. RoboICSI is highly robust compared to HP.
Suction pressure problem
To immobilize the oocyte firmly, air/oil suction is used, and a petite portion of the oocyte is repeatedly sucked into the holding pipette.[1]
This process creates tension in the membrane surrounding the oocytes and thus when an injection pipette is pushed against oolemma, the oocyte is prone to rupture. [1]
RoboICSI: This is a suction free type of immobilization.
A modification in existing holding pipette for promoting oocyte wound healing!!
New technique for mouse oocyte injection via a modified holding pipette by Lyu QF et.al . In this study, a holding pipette (HP) is modified to a trumpet-shaped opening for deeper injection into the oocyte as it is immobilized. [3]
This modified HP with trumpet-shaped opening with 45-55 micrometer ID at the end allows some zona and oolemma to be drawn into the trumpet, which provides more depth for insertion of injection pipette. The advantages of this type of modification are, they allow the oocyte membrane channel to stretch and naturally prolongs the time of extended oocyte membrane channel to return to its normal shape. As a result healing of wounded oolemma will be complete. [3]
Even in case of RoboICSI the holder is designed so that the oocyte is immobilized in such a manner that it provides more depth for deeper injection which has the same advantages as mentioned above.
Fertilization rate is higher when the sperm is deposited near the meiotic spindle
Fertilization rate is higher when the sperm is deposited near the meiotic spindle
Highest fertilization rate was found when sperm cells were injected adjacent to the meiotic spindle. It all depends on positioning of polar body relative to the opening of injection needle and this is obtained when the polar body is placed at 6’o clock position. [4]
Assumption: Immobilizing the oocyte using RoboICSI brings the polar body near to the sperm irrespective of position of polar body, either 6 or 12’o clock. When the oocyte injected from 3’o clock position, the deposition of sperm will be very near to the polar body compared to the conventional method.
Importance of cumulus and immobilizing the oocyte with cumulus
The percentage of embryos reaching to blastocyst stage in IVF is more compared to ICSI. Cumulus cells possess highly specialized trans-zonal cytoplasmic projections that pierce through zona pellucida and form gap junctions at their tips with the oocyte. This intimate association allows cumulus cells to fulfill vital roles, supporting the maturation of the oocyte and relaying endocrine and other environmental signals. According to studies performed with the oocytes possessing cumulus clusters, these type of oocytes showed significant increase in blastocyst formation. [5]
Assumption: RoboICSI can seamlessly immobilize the oocytes with cumulus and helps in injection.
References:
- https://www.researchgate.net/publication/267979757_Oocyte_Degeneration_Subsequent_Intracytoplasmic_Sperm_Injection_ICSI
- http://journals.sagepub.com/doi/pdf/10.1177/205891581000100207
- https://www.rbmojournal.com/article/S1472-6483(10)00458-X/fulltext
- https://www.ncbi.nlm.nih.gov/pubmed/10527988
- https://academic.oup.com/humrep/article/21/11/2972/2939480
Stimulated Ovulation Cycle
The main steps involved in this cycle are:
- Super-Ovulation:
Naturally, in each ovarian cycle one follicle becomes mature and gets ready for fertilization. Now women who have infertility problem and is going to undergo IVF, FSH are given as subcutaneous (under the skin) injection that will regulate ovulation, the growth and development of eggs in the ovaries.[4]
- Trans-vaginal Ultrasound:
After FSH treatment, ultrasound scans are needed to monitor the response of the follicles growth in the ovaries. The growth of the follicles is assessed by observing their increase in size using a trans-vaginal ultrasound.[4]
If the follicles seen on the scan is in the range of 16 mm to 20 mm in size, then the trigger shot is given as mentioned in the next step. This hormone initiates the final maturation and release of the eggs. This mimics the LH surge that stimulates ovulation during normal cycle.
- Taking a hCG shot:
The next step in IVF treatment is triggering the oocyte for the last stage of maturation, before retrieval. This last growth is triggered with an injection. This is also called the “hCG (human Chorionic Gonadotrophin) Trigger shot”.[4]
The injection is given when the follicles have grown in range of 16 to 20 mm in size. This shot is typically a one-time injection.
- Going for the Gold- Retrieval of Eggs:
About 34 to 36 hours after the “trigger shot” is received, the egg retrieval or ovum pick up will take place.
References:
- cimarindia.org/specialities/fertility/ivf-treatment/
- www.lifefertility.com.au/ivf-step-by-step/
- http://www.fertilitytoday.org/frequent_questions.html
- http://www.thebridgeclinic.com/Doctors-on-fertility/entryid/68/steps-to-ivf-treatment-administration-of-drugs
Introduction to RoboICSI®
RoboICSI® is an award-winning device to assist the embryologist during IVF towards improving the outcomes, thus helping infertile couples bear a child. Based on a novel design technique, RoboICSI® is a patent-pending device that will help bridge the gap between the demand and supply in the explosively growing infertility industry. It will be a Made-in-India device that will be a pioneer, offering several features for the First time in the World.
It is a smart device, which helps the embryologist to perform ICSI in an enhanced manner. RoboICSI® substitutes the holding pipette that is being used in the conventional ICSI.
Here is a quick overview about RoboICSI
Benefits of RoboICSI®
- Novel micro-manipulation
RoboICSI® offers a novel way to grasp cells using bio compatible material, which offer several advantages compared to the traditional micro-pipette aspiration-based immobilization
- Gentle handling of cells
RoboICSI® ’s intelligent passive force-limiting technology ensures that the oocyte that is grasped is not damaged even if the embryologist makes a mistake
- Quick and hassle-free installation
RoboICSI® is designed and developed keeping in mind the current devices that are used in ICSI workbenches. RoboICSI®’s plug-and-play system allows the user to quickly plug the system, perform and the auto-calibration and get started in about a day
- Easy onboarding and seamless integration
RoboICSI® is easy to learn, which allows clinics to add it into their workflow without much hassle
- Eliminates subjectivity while handling oocytes
Performs routine tasks and reduces fatigue.Augments the embryologists and maximizes their potentials
- Enables the IVF clinics to handle more volumes
Advantages of RoboICSI® over conventional ICSI
- Easy-to-handle
RoboICSI® is a robust device. It replaces the use of pneumatic pump, making it easier to handle with an easy-to-use and intuitive control.
- Not-fragile
The conventional ICSI holding pipette is made of glass and has a tendency to break while handling the oocytes. RoboICSI® replaces the glass pipette with a Holder made up of silicone elastomer, which is not fragile.
- Automated
Data is collected automatically throughout the process.
- Gentle manipulation of oocytes
The Holder which is designed to be soft, ensures no oocytes are harmed during the ICSI procedure (even inadvertently).
What is ICSI
Intracytoplasmic sperm injection (ICSI) is an ART involving the injection of a single sperm into the cytoplasm of an oocyte to achieve fertilization. It is mainly performed for the treatment of couples with male factor infertility and those with poor fertilization with conventional IVF.
ICSI is the only treatment option for couples with severe male factor infertility. It can be performed with ejaculated or surgically retrieved sperm.
Infertility Treatments
Assisted Reproductive Technology (ART), according to WHO, refers to infertility treatments where both eggs (oocytes) and sperm are handled ex-vivo to achieve pregnancy. In conventional ART procedures, the oocytes and sperms are combined in a laboratory ex vivo (i.e. outside the human body) and the resulting embryo (mature and fertilized oocyte) is implanted back into a woman.
ART’s includes techniques such as In-vitro fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI), Gamete Intra-Fallopian Transfer (GIFT) or Zygote Intra-Fallopian Transfer (ZIFT) .