ICSI, NGS TREATMENT PROCESS (Next Generation Sequencing)
NGS, or Next Generation Sequencing, is a genetic diagnostic test that allows comprehensive chromosomal screening of embryos, analyzing all 46 chromosomes. With NGS, all chromosomes that make up the embryo can be thoroughly examined.
Through NGS, embryos are screened quickly and effectively, and chromosomal problems can be detected before pregnancy. One of the most important reasons why healthy pregnancies cannot be achieved, despite successful embryo transfer during IVF treatment, is chromosomal abnormalities in the embryos.
NGS is especially recommended for:
Women over the age of 38
Couples with recurrent pregnancy loss
Couples with repeated IVF failures
Cases where chromosomal abnormalities (such as certain translocations) are detected in either parent
With the NGS method, embryos proven to be chromosomally healthy are transferred into the uterus.
Treatment Process
The first stage of treatment begins with routine medical tests. On days 2–4 of her menstrual cycle, the mother-to-be starts preliminary treatment with injections to stimulate egg maturation. For this stage, the patient does not necessarily need to be at our center; she can be monitored locally by a physician (preferably with IVF experience) under our guidance. If accommodation is available, she may also choose to undergo the entire process at our center.
Within about 10–12 days, once the eggs have reached the desired maturity, the egg retrieval procedure is scheduled. An injection is administered at the time we determine to trigger ovulation, and about 36 hours later, the eggs are collected under anesthesia. The anesthesia used is not surgical anesthesia but deep sedation, ensuring the patient feels no pain. Depending on the number of eggs, the procedure takes only 10–15 minutes, and the patient remains completely comfortable.
On the day of egg retrieval, sperm cells taken from the father are injected into the eggs using the ICSI (Intracytoplasmic Sperm Injection) technique. The fertilized eggs are then monitored in the laboratory, and embryos are observed for about 5 days. The highest-quality embryos are selected. Using the NGS method, chromosomally healthy embryos are identified and transferred to the uterus, completing the treatment.
NGS screening is performed on embryos on day 5. The analysis takes approximately 2–3 weeks. The mother-to-be then begins preparation for the transfer with her next menstrual cycle following the arrival of the NGS results.
At Cyprus American IVF Center, NGS is performed entirely in-house by our experienced embryologists and genetics team, using our state-of-the-art NGS equipment, without sending samples to external laboratories.
Stay Healthy,
Cyprus American IVF Center
Frequently Asked Questions About ICSI and NGS Treatment
What is ICSI treatment?
ICSI, or Intracytoplasmic Sperm Injection, is an IVF laboratory technique in which a single sperm cell is injected directly into an egg to help fertilization occur.
What is NGS in IVF treatment?
NGS, or Next Generation Sequencing, is an advanced genetic screening method used to examine all 46 chromosomes of embryos before transfer.
Why are ICSI and NGS used together?
ICSI is used to fertilize the eggs in the laboratory, while NGS is used to analyze the chromosomes of the resulting embryos. Together, they help create embryos and select chromosomally healthy ones for transfer.
Who can benefit from ICSI and NGS treatment?
ICSI and NGS may be recommended for women over 38, couples with recurrent pregnancy loss, couples with repeated IVF failures, or couples where chromosomal abnormalities such as translocations are detected in either parent.
What does NGS detect in embryos?
NGS can examine all 46 chromosomes and may detect chromosomal abnormalities such as missing or extra chromosomes, structural imbalances, and certain chromosomal problems before embryo transfer.
How does the ICSI and NGS treatment process begin?
The process begins with routine medical tests. Then, on days 2 to 4 of the menstrual cycle, ovarian stimulation injections are started to help the eggs mature.
Does the patient need to stay at the clinic during ovarian stimulation?
No. The patient can be monitored in her own country or region by an IVF-experienced doctor under the guidance of the clinic. If preferred, the entire monitoring process can also be completed at the center.
How long does ovarian stimulation take?
Ovarian stimulation usually takes about 10 to 12 days. The exact duration may vary depending on the patient’s ovarian response and personalized treatment protocol.
How is egg retrieval performed?
When the eggs reach the desired maturity, a trigger injection is administered. About 36 hours later, the eggs are collected under deep sedation in a short and comfortable procedure.
Is egg retrieval painful?
Egg retrieval is not usually painful because it is performed under deep sedation. The procedure generally takes about 10 to 15 minutes, depending on the number of eggs collected.
What happens on the day of egg retrieval?
On the day of egg retrieval, sperm cells taken from the father are injected into the eggs using the ICSI technique. Fertilized eggs are then monitored in the laboratory.
When is NGS performed?
NGS screening is usually performed on day 5 embryos, after they have developed to the blastocyst stage. A biopsy sample is taken and analyzed for chromosomal health.
How long does NGS analysis take?
NGS analysis usually takes approximately 2 to 3 weeks. During this time, embryos are frozen safely until the genetic results are ready.
When is embryo transfer performed after NGS?
After NGS results are received, the mother-to-be begins preparation for embryo transfer with her next menstrual cycle. Chromosomally healthy embryos are then selected and transferred into the uterus.
Why are embryos frozen during NGS treatment?
Embryos are frozen because NGS analysis takes time. Freezing allows embryos to be safely stored while the genetic laboratory completes the chromosomal screening.
Does NGS increase IVF success?
NGS may support IVF success by helping select embryos with normal chromosomal results. However, pregnancy success also depends on age, egg quality, sperm quality, embryo development, uterine health, and treatment planning.
Can NGS reduce miscarriage risk?
NGS may help reduce miscarriage risk related to chromosomal abnormalities by identifying embryos with abnormal chromosome numbers or structures before transfer.
Does ICSI and NGS treatment guarantee pregnancy?
No. ICSI and NGS treatment does not guarantee pregnancy. Success depends on many factors, including embryo quality, uterine receptivity, maternal age, sperm quality, and overall reproductive health.
What is the difference between PGD and NGS?
PGD generally screens selected chromosomes or specific genetic conditions, while NGS provides a more comprehensive analysis of all 46 chromosomes.
Why is in-house NGS testing important?
In-house NGS testing allows embryo samples to be analyzed within the same center without sending them to external laboratories. This may support better coordination between embryology and genetics teams.
What should couples consider before ICSI and NGS treatment?
Couples should understand the ovarian stimulation process, egg retrieval, ICSI fertilization, embryo biopsy, NGS testing time, embryo freezing, transfer planning, success rates, limitations, and whether NGS is suitable for their medical history.
