Invitro fertilization and ICSI

Invitro fertilization and ICSI (Intra cytoplasmic sperm injection)

Several couples face problems in normal reproduction. The reasons for this could be varied, and depending on physician’s advice, the methods used to resolve this issue are also varied. One of the ways in which couples get help is in assisted reproductive techniques. Invitro fertilization (IVF), for example, is one such technique, where the fertilization of the egg by a sperm takes place outside the body, usually in a test tube maintained under controlled ambient conditions. This technique is commonly referred to as IVF, and the children thus conceived are known as test tube babies. ICSI (Intra Cytoplasmic Sperm Injection) is a variant of IVF, the basic difference being that in IVF, the fertilization takes place in a petri dish kept under controlled conditions, whereas ICSI involved an injection which manipulates (pushes) the sperm so that it can travel easily and carry out fertilization. The sperm is injected directly into the egg.

Under normal circumstances, doctors advise using the IVF procedure, but in certain special conditions, ICSI is recommended, some of which are listed below.

Circumstances which need ICSI instead of IVF

  • Regular IVF procedure hasn’t resulted in fertilization earlier
  • Poor rate of fertilization
  • Fresh sperm not available, and frozen sperm is being used
  • Sperm Count is very low
  • The sperms do not have ideal morphology
  • The motility (flexibility in movement) of sperms is low

Comparison of IVF and ICSI

  • The rate of implantation in the embryo is similar for both IVF and ICSI
  • Mechanical implantation of sperm in ICSI
  • Several sperms used in IVF, while a single selected sperm used in ICSI
  • ICSI needs the oocytes to be properly denuded before use
  • IVF might fail in fertilization in spite of healthy sperm count and volume
  • IVF is used when the woman partner has problems in conception, whereas ICSI is used when the male partner suffers from infertility
  • ICSI carries with it a risk of genetic disorders, but that risk is minimal in IVF

So, Which Is Better?

  1. We need to understand the difference between successful fertilization of egg and successful pregnancy. IVF and ICSI have similar fertilization rates, but the pregnancy rate is much better in ICSI. The pregnancy rate increases further if the ICSI is done using PVP.
  2. As we said above, there could be unwanted alterations in the process of gene imprinting. This happens because the process of ICSI involves the removal of cumulus cells.
  3. Even though ICSI has the better pregnancy rate, there is another variant which has even better pregnancy rates, and that is IMSI. The difference between IMSI and ICSI is that when the single sperm is being selected, IMSI allows the technician to get a better view of the sperm.

Some Important Points To Check With Your Fertility Center

  • Would the fertility center have facilities for both IVF and ICSI?
  • What have been their success rates for both these procedures?
  • What is the infrastructure available to the fertility center?
  • What is the vintage of experience that the technicians and doctors have at your fertility center?