In this article:
What is IVF?
In vitro fertilisation (IVF) is a widely used fertility treatment where eggs are taken from a woman’s ovaries and mixed with sperm in a laboratory dish. The sperm naturally penetrates the egg, mimicking what happens in the body during conception. After fertilisation, the resulting embryos are nurtured in an incubator for three to five days.Doctors then select the healthiest embryos and transfer them into the woman’s uterus, where they may implant and lead to pregnancy. IVF is often recommended for various fertility issues, such as blocked fallopian tubes, ovulation problems, or unexplained infertility.
What is ICSI Treatment?
Intracytoplasmic sperm injection (ICSI) is a specialised type of IVF often used when there are male fertility issues. In this process, a single healthy sperm is carefully selected and injected directly into the centre of a mature egg using a fine needle under a microscope. This bypasses the need for the sperm to penetrate the egg naturally.Like IVF, the fertilised egg develops into an embryo in a lab for three to five days before being transferred to the uterus. ICSI is typically used when sperm quality or quantity is a concern, making it harder for fertilisation to occur naturally.
How Are IVF and ICSI Similar?
Both IVF and ICSI are types of assisted reproductive technology (ART) aimed at helping people conceive when natural pregnancy isn’t possible. They share several steps in the process:- Ovarian stimulation: You’ll receive hormone injections for 10 to 12 days to encourage your ovaries to produce multiple eggs.
- Egg retrieval: Mature eggs are collected from your ovaries through a minor surgical procedure under sedation or anaesthesia.
- Sperm collection: A sperm sample is obtained, usually through ejaculation. But sometimes surgically from the testicles or epididymis if needed.
- Embryo development: After fertilisation, embryos are cultured in a lab for three to five days and monitored for quality.
- Embryo transfer: The best-quality embryo is placed in your uterus, followed by a pregnancy test 10 to 14 days later.
Key Differences Between IVF and ICSI
IVF and ICSI follow a similar process overall, but the way fertilisation occurs sets them apart. Take a clear look at their differences:| Difference | IVF | ICSI |
| Fertilisation method | Thousands of sperm are placed with an egg in a lab dish, allowing natural fertilisation as the sperm penetrates the egg on its own. | An embryologist selects a single sperm and injects it directly into the egg’s cytoplasm using a microscopic needle. |
| Sperm requirement | Requires a higher number of sperm (50,000 to 100,000 per egg) for a chance at fertilisation. | Needs just one healthy sperm per egg. |
| Suitability | Suitable for blocked fallopian tubes, endometriosis, ovulation disorders, as well as mild male infertility. | Primarily used for severe male infertility, such as low sperm count, poor sperm motility, abnormal sperm shape, or surgically retrieved sperm. |
| Use cases | The first choice for couples with non-male-related infertility or when sperm parameters are normal. | Recommended when previous IVF cycles failed to achieve fertilisation, when using frozen eggs, or in cases of unexplained fertilisation issues. |
| Equipment and precision | Relies on natural sperm penetration, needing less technical intervention during fertilisation. | Involves advanced micromanipulation tools and a microscope, requiring a skilled embryologist to perform the injection. |
Benefits of IVF
IVF is an effective treatment with several advantages:- Broad applicability: It helps with various conditions, such as damaged fallopian tubes, endometriosis, polycystic ovary syndrome (PCOS), premature ovarian failure, or low ovarian reserve in older women (over 35).
- Higher success for female infertility: IVF often gives better fertilisation and implantation results when the main fertility challenges are related to the female partner.
- Control over timing: You can plan the treatment cycle to fit your schedule, giving you flexibility in your fertility journey.
Benefits of ICSI
Benefits of ICSI treatment include:- Effective for male infertility: It’s highly successful for men with low sperm count, poor motility, abnormal sperm shape, or blockages preventing ejaculation.
- Higher fertilisation rates: ICSI overcomes barriers to fertilisation by achieving rates of 50 per cent to 80 per cent per egg injected.
- Works with surgically retrieved sperm: ICSI can use sperm taken directly from the testicles or epididymis, giving hope to men who have no sperm in their semen.
- Useful for frozen eggs: It’s effective for fertilising eggs that have been frozen and thawed, as their outer layer may be harder for sperm to penetrate naturally.
Risks of IVF
IVF carries some risks that you should be aware of:- Ectopic pregnancy: The embryo may implant outside the uterus, such as in a fallopian tube.
- Ovarian hyperstimulation syndrome (OHSS): Hormone injections can overstimulate the ovaries, causing pain, swelling, or, in rare cases, more severe complications.
- Multiple pregnancies: Transferring multiple embryos increases the chance of twins or triplets.
- Preterm labour or birth defects: There’s a slightly higher risk of premature delivery or congenital issues compared to natural conception.
- Psychological stress: The emotional and physical demands of IVF can be challenging.
Risks of ICSI
ICSI shares many risks with IVF, but there are some specific concerns:
- Egg damage: The injection process may damage a small percentage of eggs (less than 5 per cent). Though this is rare with skilled embryologists.
- Chromosomal abnormalities: There’s a slightly higher risk of babies born via ICSI having X or Y chromosome issues. This may lead to miscarriage, heart problems, or learning difficulties.
- Low birth weight or congenital defects: There might be a minor increase in these risks, though evidence is mixed and depends on individual factors.
- Multiple pregnancies: Like IVF, transferring multiple embryos can increase the risk of twins or triplets.
Success Rates of IVF and ICSI
The success of both treatments depends on factors like your age, lifestyle, and specific fertility issues. This is what you need to know:- IVF success rates: IVF typically has a success rate of 40 per cent to 50 per cent per cycle, with higher chances for younger women and those with good ovarian reserve. Success also improves with healthy habits like a balanced diet, regular exercise, and avoiding smoking or alcohol.
- ICSI success rates: ICSI has a fertilisation rate of 50 per cent to 80 per cent per egg injected, with overall pregnancy success rates ranging from 60 per cent to 70 per cent when combined with IVF. However, pregnancy rates are similar to IVF, as they depend on factors like the woman’s age and uterine health.
Cost of IVF and ICSI
Both treatments are expensive, and costs depend on your medical needs and the clinic you go to. Here’s a breakdown:- IVF costs: In India, one IVF cycle typically costs between Rs 150,000 and Rs 250,000. This includes consultations, hormone injections, egg retrieval, fertilisation, and embryo transfer.
- ICSI costs: ICSI is slightly more expensive, ranging from Rs 240,000 to Rs 500,000 per cycle, due to the advanced equipment and expertise required for sperm injection.
FAQs on What Are The Differences Between IVF and ICSI?
- Which one is better, ICSI or IVF?
Neither is strictly better as treatment depends on your fertility needs. IVF is usually recommended when female factors are the main concern. ICSI is often used when there are male fertility problems. - Which is cheaper, IVF or ICSI?
IVF is generally cheaper. ICSI includes all the steps of IVF plus an extra lab procedure where sperm is injected into the egg, which adds to the cost.
