Dr. C K Jain

Intracytoplasmic Sperm Injection i.e. ICSI is different from conventional IVF i.e. In Vitro Fertilization because a single sperm is selected by the embryologist to be injected by a needle into the egg rather than a dish with many sperms placed near the egg so that the fastest swimming sperm enters it. Once the sperm is injected directly into the egg, it fertilizes, after which the embryo is transferred into the womb or uterus. 

Your doctor might recommend ICSI treatment for you if you have an extremely low sperm count resulting in infertility or other medical sperm conditions such as poor motility or poor morphology. It may also be suggested if prior attempts at IVF procedures have failed in fertilizing the egg or the fertilization rate is extremely low. You must also consider ICSI treatment if you resort to embryo testing or if the sperm needs to be collected from the epididymis or testicles surgically. 

However, you must keep in mind that if your partner has a genetic problem resulting in low sperm count, it could be passed on to your child, if you decide to use your husband's sperm for this process.

Success Rates of ICSI:

The success rate of ICSI treatment depends on your age and your fertility problem. Your eggs are healthier when you are young and as you age, chances are that they will become less healthy.

1. 35 per cent if you are under 35 years of age
2. 29 per cent if you are between 35 to 37 years of age
3. 21 per cent if you are between 38 to 39 years of age
4. 14 per cent if you are between 40 to 42 years of age
5. 6 per cent if you are between 43 to 44 years of age
6. 5 per cent if you are above 44 years of age

Advantages of ICSI Treatment:

Intracytoplasmic Sperm Injection gives you a chance to conceive a child genetically when most other options are exhausted. Males may be unable to ejaculate on the day the eggs are collected due to anxiety. ICSI proves to be advantageous because sperm may also be surgically extracted for this process. It is extremely helpful for those couples who suffer from unexplained infertility. However, one of the most important factors is that ICSI treatment does not affect your child's physical or mental health.

Uncommon Penis Problems: How to Handle Phimosis?

Men who suffer from phimosis might wonder what it will take to overcome the condition. The good news is that careful penis care, under a doctor's supervision, is likely to solve the problem with time and patience. However, there are other options as well. Here's what a man needs to know about this uncommon penis problem.

What is phimosis, anyway?

Phimosis is a condition in which the foreskin of the penis cannot retract beyond the head of the penis. Obviously, this is a condition found only in intact men. Being unable to retract the foreskin is actually very common in babies and young children, but as they begin to mature, the foreskin should eventually move freely over the head of the penis.

For some men, however, the problem never resolves. Or perhaps it does, but then suddenly becomes an issue again for no apparent reason.

There are several different types of phimosis:

1) Pathological phimosis is when the ability of the foreskin to move is reduced by infection, inflammation or scarring. This is the most unlikely cause, but it does happen to men of any age.

2) Congenital phimosis means that the foreskin has been tight since birth, and that it didn't loosen up with time. This isn't caused by any sort of medical condition, trauma or the like. Fortunately, this is the easiest to treat.

3) Common phimosis is usually found in young male children, when the foreskin adheres to the head of the penis. This is something a boy grows out of over time; if he does not, it will become apparent that common phimosis is actually congenital phimosis.

What's the treatment for phimosis?

When it comes to treatment of phimosis, there are several ways to go. In the earliest stages, there is often a 'wait and see' approach. During this time, a man can try numerous types of manual stretching to see if the problem resolves on its own. This stretching is quite similar to masturbation, as a man simply works to move the foreskin up and down, gradually opening it up a bit more to allow for it to retract. However, in extremely tight cases this might not work.

Another option is medication. Two drugs that have been tried with some success include betamethasone and hyaluronidase. When given to young men in a study, there was a 54% success rate when they were given the combination, and all patients tolerated the medication very well.

However, the above methods don't have the best success long-term. That's why many doctors look to surgery as the answer. Circumcision is the most common treatment for phimosis, as it removes the foreskin and immediately resolves the issue. However, some men will opt for a partial circumcision, which means that the surgeon makes a series of tiny incisions in the foreskin to help it open up, but doesn't remove it entirely.

Keep in mind that surgery is often not recommended when a man is young, as everyone develops differently and phimosis might go away on its own as he matures. However, those over the age of 18 might be a candidate for circumcision if this penis problem continues and causes significant discomfort or an inability to enjoy sexual pleasure.

Those who are trying to use the manual method to stretch the foreskin might have better luck if they employ a specially formulated penis health crème (health professionals recommend Man 1 Man Oil, which is clinically proven mild and safe for skin) during each attempt. The right crème will contain Shea butter and vitamin E, which provide ample hydration to soothe the skin and keep it as pliable as possible, thus possibly enhancing the work a man does to resolve phimosis through manual stretching.

In a normal pregnancy, the egg that the ovaries release enters the fallopian tube. If a sperm fertilises it, the fertilised egg attaches itself inside the uterus. However, sometimes the fertilised egg can attach itself outside the uterus. This condition is called ectopic pregnancy.

Ectopic pregnancy can be detected in the first few weeks of the pregnancy itself. If your doctor does discover ectopic pregnancy, you would need immediate medical attention. Ectopic pregnancies can be sad and scary. The survival rate of the baby is extremely low, and you may need some time to get over your loss. Fortunately, one ectopic pregnancy doesn't mean you can never conceive again. Many women who lost their first baby to ectopic pregnancy have been able to have a healthy and normal pregnancy the second time around.

The causes of ectopic pregnancy include:

1. An inflammation or infection of the fallopian tube can lead it to become entirely or partially blocked.
2. Scar tissue from a surgery or an infection of the fallopian tube may also hinder the movement of the fertilised egg.
3. Surgery in the tubes or pelvic areas in the past might cause adhesions.
4. Birth defects or abnormal growths can cause anomalies in the shape of the tube.

These causes are usually followed by certain risk factors, such as:

• Age (The age group of 35-44 especially)
• An ectopic pregnancy in the past
• Previous abdominal or pelvic surgery
• PID (pelvic inflammatory disease)
• Several prompted abortions
• Conceiving with an intrauterine device in place
• Smoking
• Endometriosis (growth of uterus lining tissues outside the uterus).
• Fertility treatments.

The signs and symptoms of ectopic pregnancy include:

1. Minimal vaginal bleeding
2. Vomiting and nausea with pain
3. Pain in the lower abdomen
4. Sharp cramps in the abdomen
5. Localised pain (Pain concentrated on one side of your body)
6. Pain in your neck, rectum or shoulder
7. Rupture of the fallopian tubes can cause fainting due to the bleeding and pain

The treatment of ectopic pregnancy can be any one of the following:

1. If the pregnancy has not progressed too far, methotrexate will be administered. This absorbs the pregnancy tissue and can save the fallopian tubes.
2. The tubes may be removed if they have ruptured or stretched, and have started bleeding.
3. Laparoscopic surgery (operations performed by making minor incisions) may be performed to remove or repair the tubes and recover the ectopic pregnancy. If you wish to discuss about any specific problem, you can consult a gynaecologist.