ICSI or IVF: Which Treatment Should You Opt for?

The field of infertility has seen an unprecedented advancement in the last few decades. The physiology of ovulation is better understood today through the development of better diagnosis methods. Whether ICSI or IVF, it helps you have a baby using different fertility treatments. 

Advanced reproductive technologies (ART), which is the foundation of modern infertility management, have given hope to the parents who want to get pregnant and have a child. Though in vitro fertilization (IVF), a conventional method, has been a treatment for these parents, the emergence of intracytoplasmic sperm injection (ICSI) has made it choose over IVF owing to its increasing use recently. 

How Is ICSI Different from IVF?

Intracytoplasmic sperm injection or ICSI is a treatment method, in which a single, healthy sperm is chosen and carefully injected into the egg by an embryologist in a laboratory. With this technique, fertilization of eggs is attained in the lab and then, the embryo is transferred to the uterus or womb. 

The IVF treatment, on the other hand, also helps women become pregnant through fertilization of eggs and development of embryos and implantation. The process involves medication to make eggs mature, which are taken out for fertilization in a specialized lab. When the eggs are fertilized, the doctor transfers one of more eggs to the uterus. Both ICSI IVF is performed by implanting the embryo(s) in the lining of a woman’s uterus, and only the initial process differs.

Also, Read: Success Rate Of ICSI

Whether ICSI or IVF – Which Should You Consider?

Research shows that both ICSI and IVF are effective depending on the circumstances. The introduction of IVF in 1980s assisted several couples, who had been infertile, have babies; however, the treatment was not successful with couples, in which the men had low sperm count. This led to the development of ICSI, which was effective even in couples with male factor infertility. Despite the widespread use of intracytoplasmic sperm injection procedure in couples with non-male factor infertility, its effectiveness in these patients still requires much evidence for confirmation.

When ICSI is considered the best option in the cases of failure of fertilization owing to immunological infertility and ejaculatory dysfunction, its safety is not guaranteed. The procedure if used unnecessarily has worked out expensive and unethical. However, this does not apply to patients with severe male-factor infertility. Research studies show ICSI as a highly advanced treatment procedure for male infertility and its use has extended recently for non-male factor infertility too. The risk of oocytes getting damaged is possible in ICSI and may reduce the chances of fertilization, as well as pregnancy.  

Some comparison studies of ICSI IVF showed that the fertilization rates, as well as the implantation rates were considerably higher in the IVF procedure than the ICSI procedure. Similarly, it was found that the percentage of chemical and clinical pregnancy was also statistically higher in IVF than that in ICSI. IVF was considered superior to ICSI in some studies associated with the normoresponder patients with non-male factor because of no improvement in the percentages of fertilization, implantation and clinical pregnancy among these patients in ICSI. 

This raises a question as to when ICSI is used and the results of the study show that it is especially in the case of severe male-factor problems instead of non-male factor infertility, and further, it did not relate to improved fertilization and pregnancy rates.

Also, Read: Things You Need to Know About ICSI

For Whom Should ICSI Considered for:

The couples with male-factor infertility, especially in which case the man’s semen is regarded an abnormal semen analysis, ICSI is absolutely essential. Some reasons why couples decide to go for ICSI are:

  • Failed fertilization in the last IVF treatment
  • Unexplained infertility
  • Very low sperm count
  • Sperms fail to move properly
  • High percentage of abnormal sperms
  • Retrieving sperms by electro-ejaculation or retrieving directly from the testicles (TESA) or from the epididymis (PESA)
  • In the case of frozen sperms 
  • Semen with high levels of antibodies

For Whom Should IVF Considered for:

You May Be Asked to Opt For IVF in the Following Cases:

  • Ovulation problems because of hormone imbalance, which is called polycystic ovarian syndrome (PCOS).
  • Low sperm count
  • Problems associated with fallopian tubes
  • In case one of you is sterilized 
  • Avoid any genetic disorders in the baby
  • Endometriosis

Various Risks Involved with ICSI and IVF

Both ICSI and IVF are recommended by doctors based on the circumstances such as emotional difficulties and psychological demand. However, both these treatments are associated with risks and they are:

  • In the case of hormone medications, the ovaries swell owing to excess hormones causing ovarian hyperstimulation syndrome (OHSS)
  • Multiple birth i.e., giving birth to twins and triplets
  • Premature labor 
  • Caesarean delivery
  • Low birth weight
  • A low risk of birth defects 

In conclusion, choosing between ICSI and IVF is primarily based on the initial infertility test. The other factors to be considered are your age and medical history, as well as the results of previous treatment cycles you might have had earlier.

Also, Read: Why Couples Should Opt for IVF

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