When it comes to assisted reproduction, there are few treatments as popular or effective as IVF and ICSI. But what is the difference between the two, and how can you know which is better for your fertility journey?
Understanding IVF
In Vitro Fertilisation (IVF) is a procedure that helps couples conceive when they have been struggling to do so naturally. A cycle of IVF involves a female patient going through hormone stimulation to help multiple eggs mature in their ovaries. These eggs are then retrieved from the ovaries and each healthy egg is combined with a sperm sample in an attempt at fertilisation. We hope to create as many viable embryos as possible. A healthy embryo is implanted directly into the uterus, while others that have sufficiently developed are frozen for later use.
You can learn more about IVF, its typical process and other key information here. While Intracytoplasmic Sperm Injection (ICSI) follows most of these steps, there is a key difference between the two.
What is the difference between IVF and ICSI?
ICSI is not actually a different treatment from IVF, but rather a specialised form of it, used to address specific known infertility issues. In particular, ICSI is prioritised in cases when male infertility is a known barrier to natural conception.
The primary difference between IVF and ICSI is the method of fertilisation. In standard IVF, a sample of sperm is placed with an egg, mimicking the natural process of fertilisation that occurs within the body where many sperm attempt to fertilise a single egg. In ICSI, instead of placing an entire sperm sample with an egg, only a single sperm is selected instead.
The total sample is closely analysed to determine which sperm is the healthiest, based on its movement (motility) and shape (morphology). Sperm that are healthier in these regards have a greater chance of successfully achieving fertilisation. Once the healthiest sperm has been selected, it is carefully drawn into a needle and then injected directly into the centre of the egg.
When is ICSI used instead of conventional IVF?
As mentioned, ICSI is used to overcome different aspects of male infertility when they are a known contributor. A fertility specialist may opt for ICSI in cases of a low sperm count, poor sperm morphology and/or motility, or azoospermia. Each of these can make it difficult to achieve fertilisation in IVF or through intercourse, but the direct selection of the healthiest sperm can help to bypass these issues.
ICSI is also used for couples who have not been able to achieve fertilisation through standard IVF.
Is ICSI better than IVF?
ICSI may seem that preferable over standard IVF with a more deliberate process of selecting the healthiest options for fertilisation. Naturally, in cases of male infertility, ICSI may in fact lead to a slightly higher chance of achieving successful fertilisation and pregnancy than conventional IVF.
However, in cases without male infertility as a contributing factor, the success rates are essentially the same. As with standard IVF, success rates for fertilisation and pregnancy also increase with each successive cycle, known as the Cumulative Live Birth Rate.
Risks
Overall, we typically recommend that patients go through traditional IVF unless their particular circumstances would make ICSI more appropriate. In addition to having a near-identical success rate, IVF is also a less invasive procedure with fewer risks.
That isn’t to say that IVF doesn’t carry its own risks, but some are more specific to ICSI. For example, it is possible that one or more eggs could be damaged as a result of the needle insertion. It is an unlikely occurrence, but is an aspect that doesn’t occur in the standard IVF process. Additionally, while ICSI can help to overcome male infertility, it may also mean that the same impairments could be passed to any male children produced.
Unfortunately, there is no way to guarantee success with either treatment, as much as we wish we could. However, we ensure that every patient and couple has a thorough assessment of their health and unique circumstances, so that we can make the best treatment recommendation with the highest likelihood of success.
Making the right decision
Overall, there are different pros and cons of ICSI in the same way that there are with any fertility options. The right treatment will depend on your individual circumstances and fertility goals.
It can be hard to figure out what might be holding you back from falling pregnant. We make that process as easy as possible, guiding you through every step and making recommendations to suit your situation. If you’re interested in learning more about how we can help, get in touch to book a consultation.
