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IVF vs ICSI: Key Differences Explained
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This information has been reviewed and approved by an experienced fertility specialist at Indira IVF to provide accurate and up-to-date guidance for our readers.
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Disclosure
The information provided here serves as a general guide and does not constitute medical advice. We strongly advise consulting a certified fertility expert for professional assessment and personalized treatment recommendations.
Synopsis
IVF and ICSI, the two major assisted reproductive technologies, have been transforming the way infertility is treated since their inception. Both processes share the same goal of helping couples achieve parenthood. But do IVF and ICSI follow the same process? And, if not, where do these methods differ? And, do any of these two methods have advantages over the other? Understanding IVF vs ICSI cost comparison helps couples plan financially, as ICSI typically involves additional lab techniques that affect pricing.
This article answers all these questions in detail:
What is IVF?
In Vitro Fertilisation (IVF) is one of the most trusted and used fertility treatments, which is designed to help couples struggling to conceive naturally. The name ‘In Vitro’ basically means in glass, which means the procedure of fertilisation happens outside the human body in glassware laboratory equipment. If fertilised, this egg, which by now is an embryo, is transferred to the woman’s uterus. Every one of these steps is performed with great care and under close observation so as to avoid any complications during the procedure.
Key Steps in the IVF Process:
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Ovarian Stimulation:
Fertility drugs stimulate the ovaries to produce multiple eggs in a single cycle.
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Egg Retrieval:
The mature eggs are retrieved from the ovaries through a minimal surgical procedure done under sedation.
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Sperm Collection and Preparation:
A semen sample is obtained and processed in order to yield the healthiest sperm possible.
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Fertilisation:
The eggs and sperm are placed together in a dish to allow fertilisation to occur on its own.
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Embryo Development -
The fertilised eggs (embryos) are observed in the laboratory setting for a period of 3-5 days.
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Embryo Transfer -
Embryos are transferred inside the uterus of the woman either one at a time or in multiples.
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Pregnancy Test -
A pregnancy test is done around two weeks later, which is a blood test to determine if the embryo has implanted properly.
When IVF is Recommended
IVF is mostly the first line of treatment for infertility, no matter its underlying cause. However, there is a wide range of fertility issues for which IVF is mostly suitable and recommended:
- Blocked or damaged fallopian tubes
- Endometriosis
- Ovulation disorders or low levels of ovarian reserve
- Decline in fertility due to increasing age
- When other fertility treatments fail to work
- Unexplained infertility (when no clear medical cause is found)
What is ICSI?
Intracytoplasmic Sperm Injection (ICSI) is a special case of IVF, used to cope with severe male infertility. In contrast to IVF, where the egg enables natural selection of a sperm, in ICSI, a single healthy sperm is injected directly into the egg. An extremely precise technique, ICSI is performed under high power of magnification, using a fine glass needle. Once injected, the fertilised egg is transferred to the uterus, as with all IVF cycles.
Key Steps in the ICSI Process:
- Ovarian Stimulation and Egg Retrieval – Similar to IVF, hormones are given to stimulate the ovaries to produce multiple eggs, which are then surgically retrieved.
- Sperm Selection – A single healthy sperm is identified from the ejaculate specimen or surgically removed.
- Microscopic Injection – A micromanipulation system is employed to inject a single sperm directly into the egg.
- Fertilisation and Embryo Development – The egg develops into an embryo in the lab after fertilisation.
- Embryo Transfer – One or more embryos are transferred to the uterus of the woman.
- Pregnancy Testing – After a period of two weeks, a blood test can be done to confirm successful implantation of the embryo(s).
When ICSI is Recommended:
ICSI, as mentioned earlier as well, is a very useful process when male infertility is involved in multiple failed conceptions. As the method is highly specific, it can be recommended when:
- The reason for infertility is low sperm count, poor motility, and abnormal shape of sperm
- When sperm need to be retrieved surgically
- Multiple IVF failures happen due to low sperm count or poor motility
- Couples with unexplained infertility issues have low chances of success in other methods
Success Rates: IVF vs ICSI
When comparing ICSI and IVF success rates, factors such as the female’s age, egg quality, and medical history play a major role. While both techniques are very effective, in some cases IVF may have the upper hand, while in some instances ICSI may. For example, the success rates for ICSI are way too high in comparison to IVF in cases of severe male infertility. However, in cases of non-male factor and normoresponder, IVF has better success rates than ICSI.
Besides this, the success rates of IVF as well as ICSI also depend upon several factors that depend on any patient’s individual requirements and conditions. For example, the success rates of IVF and ICSI largely depend upon the age of the woman; that is, women under 35 have higher success rates than their counterparts.
Cost of IVF and ICSI
When it comes to advanced fertility treatment like IVF and ICSI, the cost of the treatment becomes an important factor for any couple. The exact numbers for both of these treatments can vary largely based on different factors, such as:
- Additional procedures, like embryo freezing, genetic counselling, etc.
- Medications used
- Extra pre- and post-surgery tests
- The number of cycles
- Geographical location of the fertility clinic
In comparison of the cost of IVF with ICSI, IVF is a standard fertility treatment where sperm & egg are combined in a laboratory dish, whereas ICSI follows the same procedure with an extra step of injection of sperm with a fine needle and microscope. Therefore, this extra step in the procedure also adds to the overall cost of ICSI.
Risks of IVF and ICSI
While both IVF and ICSI are safe and widely practised, it is important to note that for couples, no medical procedure is completely risk-free. The potential risks are generally low, but being aware of them helps couples make informed decisions and prepare for the journey in advance.
| Risks Linked with IVF | Risks Linked with ICSI |
|---|---|
| Egg stimulation medications can directly influence and initiate the Ovarian Hyperstimulation syndrome, which can, in turn, cause swollen and painful ovaries, bloating, and discomfort. | As ICSI includes direct contact of a sharp micro needle with the egg, there remains a small risk of damaging the egg during this process. |
| Transfer of more than one embryo is common in IVF to increase the chances of successful conception. However, if all these embryos get implanted, the risk of multiple pregnancies can increase, thereby increasing the risk of preterm birth. | In cases where male infertility is caused by hereditary disorders, there remains a strong chance of passing such an issue to the next generation of males. Therefore, genetic counselling is also recommended to detect such disorders early on. |
| Although very rare, the minor surgical procedure during egg retrieval can cause bleeding, infection, or injury in the nearby area. | As per some studies, there is a very small number of ICSI cases where chromosomal abnormalities have been seen. |
| Despite having a good chance of success with healthy eggs and sperm, the failure of fertilisation still lingers, which in turn increases the cost of IVF per cycle. | ICSI, unlike IVF, is a lab-heavy procedure which totally depends upon the lab equipment and skills of embryologists, which can sometimes be risky. |
Choosing Between IVF and ICSI
The decision to choose IVF or ICSI mainly depends on the cause of infertility and medical history. IVF is usually recommended when the infertility is unexplained, in cases of female factor infertility, such as blocked tubes or endometriosis, or when the parameters of sperm are normal. ICSI is usually offered if there is severe male infertility, if all IVF fertilisations have failed in the past, or if the sperm is surgically retrieved or frozen. In the end, you should always follow the path determined by your fertility specialist after reviewing your clinical, emotional, and personal factors.
Conclusion
In conclusion, the journey to parenthood has been transformed with hope for couples experiencing infertility with IVF and ICSI. IVF remains the favoured procedure for most couples, while ICSI serves an important and useful role among couples with male factor infertility and/or for couples who have previously failed an IVF procedure. There isn't one treatment that is better than the other; the ideal choice will depend on medical, psychological, and personal factors. With the expertise of their fertility care provider, couples may make informed choices about their family needs and get one step closer to their goal of parenthood.
Frequently Asked Questions
Is it possible to switch from IVF to ICSI during the procedure?
Yes, if there is no fertilisation from IVF, your doctor may attempt conversion to ICSI by using the same eggs, in certain cases.
Is there an increased risk of birth defects with ICSI?
It has been shown that ICSI is relatively safe. However, ICSI may have slightly more opportunity for genetic issues, given the underlying male factor infertility.
How many embryos are usually created in IVF vs ICSI?
While embryo production varies by egg quality, often ICSI allows for more eggs to be fertilised in situations of male fertility issues.
Do lifestyle changes matter for IVF and ICSI?
Absolutely. Quitting smoking, managing stress, maintaining a healthy weight, & eating a balanced diet all matter in improving outcomes.
Is ICSI better than IVF?
Not necessarily. ICSI is only recommended when there are specific male factor infertility or other fertilisation issues.
