Fertility treatments have offered hope to countless couples who face difficulties in conceiving a child. Among the most well-known and widely used methods are IVF (In Vitro Fertilisation) and ICSI (Intracytoplasmic Sperm Injection).
Though both procedures are designed to help with fertilisation, they differ in technique, suitability, and success rates based on specific fertility challenges. Understanding how these two treatments work can help individuals make informed decisions during their fertility journey.
What is IVF?
IVF stands for In Vitro Fertilisation. It is one of the simplest and most frequently applied methods of assisted reproductive technology (ART). The term “in vitro” means “in glass”, and that is where the process occurs.
In IVF, the woman’s ovaries are induced to produce several eggs. These eggs are then retrieved and placed together with sperm in a laboratory culture dish. If fertilisation takes place, the embryos are cultured for a few days, and one or more are then placed in the woman’s uterus. The idea is that at least one of them will implant and result in pregnancy. IVF is usually advised to couples experiencing the following situations:
- Blocked or damaged fallopian tubes
- Ovulation disorders
- Unexplained infertility
- Mild male factor infertility
What is ICSI?
ICSI stands for Intracytoplasmic Sperm Injection and is a sub-type of IVF. It is similar to the preparation process in terms of ovary stimulation and egg retrieval. However, the fertilisation step is very different.
In the IVF and ICSI process, rather than placing the sperm and egg in a dish and allowing them to swim together, as in IVF, ICSI involves injecting a healthy sperm directly into the middle of each egg using a thin glass pipette. This direct method is useful in the treatment of some types of male infertility, particularly when sperm production is low or of poor quality. The following are some of the situations where ICSI is most often applied:
- The male partner has a very low sperm count.
- The sperm has low motility. Therefore, cannot move in the female reproductive tract properly.
- The sperm can’t penetrate the egg on its own.
- In previous IVF attempts, fertilisation was not achieved.
IVF and ICSI: The Key Differences
Even though IVF and ICSI share some of the processes, which are performed before and after fertilisation, there are certain differences between them.
- Fertilisation Method
The main difference is that fertilisation is accomplished differently. In IVF, sperm are allowed to fertilise the egg on their own in the dish used in the laboratory. This is similar to natural fertilisation, but it is done outside the body.
In ICSI, one sperm is selected and then placed into the egg by the use of a microscope, which enhances the fertilisation rate when the sperm is of poor quality. This is a significant factor when comparing IVF and ICSI, especially for couples with male-factor infertility challenges.
- Male Factor Infertility
IVF is appropriate when the sperm sample is normally motile, even if not highly so. However, if the sperm sample is poor, then ICSI is usually the better option to be used. It requires only one sperm to penetrate the egg, and therefore, even if sperm count or motility is low, ICSI can still work.
- Control Over Fertilisation
ICSI provides fertility specialists with more control over the fertilisation process step. They can pick a healthy-looking sperm under the microscope and then inject it into the woman’s egg. In IVF, fertilisation is more of a race between the sperm, and the success may depend on how well the sperm can get to the egg and penetrate it.
- Usage Trends
In the recent past, ICSI has been applied even where there is no significant male infertility factor present. It is now incorporated in many clinics as a standard procedure in IVF and ICSI treatment, even if it is not always required. It is determined by the couple’s background, the results of the tests, and the advice of the doctor.
Success Rates: Is One Better Than the Other?
ICSI and IVF are quite effective, but the success of the procedure varies depending on factors such as age, quality of the eggs, sperm quality, and fertility history. Research also indicates that pregnancy rates with ICSI can be higher, especially in cases of male factor infertility. Nevertheless, the overall pregnancy and birth rates are almost the same when drawing IVF and ICSI comparisons in couples with no male factor infertility. In general:
- IVF has a fertilisation rate of about 70% per mature egg
- ICSI has a slightly higher fertilisation rate of up to 80% in some cases
It is important to note that ICSI does not ensure pregnancy, as it is a technique that is used to increase the chances of conception. However, the later processes, such as embryo development, implantation, and pregnancy, are still influenced by several natural factors.
Risks and Considerations
Both procedures are safe. However, some things should be taken into consideration.
With IVF:
- One of the possible side effects is ovarian hyperstimulation due to the fertility medication.
- In some cases, multiple embryos are transferred, and this results in multiple births, such as twins or triplets.
With ICSI:
- The process is more invasive at the microscopic level.
- The only disadvantage is its slightly higher cost due to the technical procedures that are followed.
There are some reports that genetic or developmental problems may be slightly higher, particularly if the sperm quality is very low. However, more research is required to understand these risks and come up with better ways of managing them.
Choosing the Right Treatment
It is not always easy to decide between IVF and ICSI. It involves a medical examination of partners, and various tests may be conducted. ICSI is used in cases where previous IVF attempts have not been successful, or if there are problems with sperm.
In some cases, couples may undergo IVF and then transfer to ICSI if the need arises. It is always advisable to consult with a fertility specialist on the patient’s medical history, financial plan, and emotional state to choose the best plan.
Conclusion
In as much as assisted reproductive technologies are concerned, both IVF and ICSI have been established to be effective in helping couples conceive. The main difference is the way the egg is fertilised, IVF allows nature to take its course in the laboratory, while ICSI allows the scientists to intervene and ensure that fertilisation occurs.
A proper comparison between IVF and ICSI can be made only when the nature of the couple’s infertility is known. Although IVF is effective for many patients, ICSI is a viable option when sperm problems exist. Altogether, these techniques remain a revolutionising solution in the lives of many people by creating parenthood chances for those with fertility issues.
