IVF with ICSI in Turkey

ICSI addresses fertilisation. If sperm cannot reach or penetrate the egg, injecting one directly gets past that barrier, and for severe male factor it is the difference between having embryos and having none.

It does not improve egg quality, it does not compensate for age, and it does not make an embryo more likely to implant. Those are separate problems with separate answers, and a technique aimed at fertilisation cannot fix any of them. Be careful with any explanation that presents ICSI as generally improving your chances rather than solving a specific problem.

• Male factor infertility

  Low count, poor movement or abnormal shape. The clearest indication, and the situation ICSI was developed for.

• Surgically retrieved sperm

  Where there is no sperm in the ejaculate and it is taken directly from the testicle or epididymis. That retrieval is its own procedure with its own consent and its own risks.

• Previous fertilisation failure

  A prior conventional IVF cycle where few or no eggs fertilised. A recognised reason to change technique.

• No male factor at all

  Ask why. The evidence does not show a benefit over conventional IVF in this situation, and the question is a fair one.

For the cycle around it, see IVF in Turkey. For sperm selection add-ons, see IVF with IMSI. For treatment where the eggs are donated, see donor egg IVF. For the wider fertility offering, see fertility in Turkey.

1. 1

   Assessment of both partners

   Ovarian reserve and the uterus, and a proper semen analysis, repeated if abnormal. ICSI is a decision made from that assessment, not a default.
2. 2

   Genetic testing where indicated

   For severe male factor, before treatment rather than after a pregnancy. Ask what is being tested and who explains the result.
3. 3

   Stimulation and monitoring

   Injections to grow multiple follicles, with scans and blood tests. Ask who monitors you if part of this happens at home before you travel.
4. 4

   Egg collection and sperm preparation

   Eggs are collected under sedation. Sperm is prepared, or retrieved surgically if that is the plan.
5. 5

   The injection itself

   Each mature egg is injected with a single selected sperm. Not every egg is mature, and not every injected egg fertilises. Ask to be told both numbers.
6. 6

   Transfer and what is left

   One embryo is usually transferred. Ask what happens to any others, what storage costs, and for how long.

• Ask why ICSI for you specifically. And accept a specific answer. If there is no male factor and no previous fertilisation failure, the question deserves a real reply.
• Ask about genetic testing before treatment. Particularly with severe male factor. It is standard practice and it is easy to leave out of a package.
• Ask how the monitoring works across two countries. Which scans happen at home, who reads them, and how the dates are coordinated with your flights.
• Ask how many embryos they transfer. And say what you want. One at a time is the safer answer for most people, and a twin pregnancy carries higher risks.
• Ask about storage. What it costs, for how long, and what happens if you stop paying or cannot be contacted.
• Arrange follow up at home. A blood test to confirm pregnancy, then early scans, and a clinician who has the records of what was done.

• Not every egg survives injection. A proportion of eggs are damaged by the procedure. Ask what the clinic sees and how they report it to you.
• Fertilisation is not certain. Even with ICSI, some cycles produce no fertilised eggs. Ask what the plan would be.
• Ovarian hyperstimulation. A risk of the stimulation rather than of ICSI itself, and one to recognise: rapid bloating, breathlessness, reduced urine output.
• Multiple pregnancy. Comes from transferring more than one embryo, and it carries higher risks for mother and babies.
• Passing on a genetic cause. The reason for testing and counselling before treatment in severe male factor.
• The emotional weight. Cycles fail, and doing it in another country adds distance to that. Ask what support exists and who you speak to.

• American Society for Reproductive Medicine, committee opinion on ICSI for non male factor indications.
• Human Fertilisation and Embryology Authority, patient information on ICSI and treatment add-ons.
• European Society of Human Reproduction and Embryology, guidance on assisted reproduction practice.
• NHS, information on IVF and fertility treatment.
• Turkish Ministry of Health, register of facilities authorised for health tourism.