Which technique is the best for you - IVF OR ICSI ?

Assisted Reproductive Techniques like In Vitro Fertilization (IVF) and Intra Cytoplasmic Sperm Injection (ICSI) are sought after by a large number of childless couples across the globe. While these treatments give people a ray of hope, the success of these procedures varies from person to person and treatment to treatment. We bring you a comprehensive guide to IVF and ICSI – what these terms mean, how these treatments are performed, and which is the ideal assisted reproductive technique for you.

Understanding IVF

In Vitro Fertilization is a process of fertilization where an egg is combined with sperm outside the body, in vitro. Upon the successful fertilization of the egg, the embryo formed is allowed to develop in the laboratory. Later, it is transferred to the women’s uterus for where it gets implanted and develops further.

An IVF cycle consists of five chief steps:

1. Controlled Ovarian Hyper stimulation (COH) and Follicular Monitoring
2. hCG Trigger and Oocyte Retrieval
3. Oocyte Culture, Insemination and Fertilization in the IVF Laboratory
4. Embryo Transfer
5. Luteal Support

Understanding ICSI

Intra Cytoplasmic Sperm Injection (ICSI) involves the insertion of a single sperm directly into the cytoplasm of a mature egg (called oocyte). Taking the IVF procedure one step further, ICSI uses a special micro-injection pipette (glass needle).

Is IVF the right treatment for me?

According to Dr Gautam Allahbadia, from Mumbai; IVF is suggested to patients when alternative treatments either are unlikely to achieve the desired results, or fail to result in a pregnancy. IVF treatment is best suited for women with blocked fallopian tubes or extensive pelvic adhesions preventing the egg from entering the fallopian tubes.

IVF is also suggested in cases where the male partner is suffering from low sperm counts. Since IVF allows super concentrating sperm, successful fertilization can occur even despite the male partner having low sperm counts.

The treatment is also advisable in cases of “unexplained infertility”, which refers to the condition when a couple is unable to conceive despite all tests being normal. In such cases, IVF is a viable option even if you have failed to conceive with Intrauterine Insemination (IUI), suggests Dr Gautam Allahbadia, who heads the IVF team at Millennium Medical Center (MMC) IVF, Dubai.

IVF is also advisable to women having Polycystic Ovaries (PCOS), and in cases where ovulation induction with or without IUI has remained unsuccessful. Women having mild to moderate Endometriosis can try undergoing IUI before proceeding to IVF, suggests Dr Gautam Allahbadia.​

Is ICSI the right treatment for me?

Intra Cytoplasmic Sperm Injection (ICSI) has emerged as a break through technique in the treatment of male infertility. The procedure is preferred in cases where the male partner’s number of motile sperm is very low, or the morphology is excessively poor. Fertility and IVF consultant Dr Gautam Allahbadia recommends ICSI based on the results of the semen analysis, along with other risk factors.

Health risks involved in IVF and ICSI cycles

The drugs used during IVF and/or ICSI cycles might cause some side effects on occasion. The procedures also come with a small but significant risk of multiple pregnancies, pelvic infection and ectopic pregnancy. Controlled Ovarian Hyper-stimulation (COH) involved in IVF treatments is associated with a risk of Ovarian Hyper stimulation Syndrome (OHSS). Common symptoms of OHSS (in varying degrees of severity) include the following: nausea, diarrhea, vomiting, extreme bloating, rapid weight gain, and difficulty in breathing. These symptoms are closely monitored by the doctors to prevent the occurrence of hyper-stimulation.

Success Rates for IVF and ICSI procedures

Talking about the IVF cycle success rates, Dr Gautam Allahbadia says, “The woman’s reason for the infertility, and her age are the two most significant factors that determine the success of an IVF cycle. We discuss the patients’ individual case history before coming up with a treatment plan for them, since each patient is unique.”

As the ICSI procedure fertilizes about 50 to 80 percent of eggs, it is commonly assumed by patients that all eggs will get fertilized during the procedure. However, it is important to note that even when a sperm is injected into the egg, fertilization can’t be guaranteed. Post fertilization, the success rates for ICSI and IVF procedures remain the same.