Difference between ICSI and IVF

Intracytoplasmic sperm injection (ICSI) and In Vitro Fertilization (IVF) are the two common procedures for tackling infertility. The major difference between IVF and ICSI is the process through which the sperm and egg are introduced.

Intracytoplasmic sperm injection (ICSI)

In ICSI technique a single sperm is selected with a fine glass needle and is injected directly into each egg. This procedure is performed in the laboratory by competent embryologists using specially designed equipments. The technique requires fewer numbers of sperms and the ability of the sperm to penetrate the egg is also assisted.

Ideal Candidates for ICSI

• Low sperm count
• Less motile or abnormally shaped sperm
• Sperm retrieved from urine or through electro ejaculation
• Semen with elevated level of antibodies
• Failure of IVF
• To test the embryos to prevent passing on a genetic abnormality.

Procedure

The doctor will order an ultrasound or blood tests, to monitor the stage of the treatment. Once the eggs are ready for retrieval, the couple will undergo separate procedures. The sperm has to be ejaculated on the same day as the eggs are collected. If sperm is not present in semen the physician will use a fine needle to collect the sperm. This procedure will be done under a local anesthetic. The collected sperms are then frozen.

While collecting the eggs the patient will be sedated. The doctor will retrieve the eggs using a fine, hollow needle, attached to an ultrasound probe. Progesterone is given in the form of a pessary or an injection of progesterone gel to help the lining of the uterus prepare for egg retrieval. The patient might feel a bit bruised and sore after egg transfer and may have slight bleeding.

Further the embryologist isolates individual sperm in the laboratory and injects them into the individual eggs. Within two days, the fertilized eggs will turn into embryos. The doctor will transfer one or two embryos into the uterus, through the cervix, using a fine catheter. If the procedure is successful, the embryo will attach to the wall of the uterus and continue to grow to become the baby. After about two weeks, a pregnancy test can be performed.

Success rate

Success rates of the treatment differ between patients, particularly according to the age of the woman undergoing treatment, but it can be approximated that about 25% of patients will have a baby after one attempt at ICSI.

Cost

ICSI treatment cost in India depends on the hospital and the advanced treatment facilities available. The cost of the procedure can be approximated to around 1 lakhs to 1.5 Lakhs INR in India. This includes the cost of the basic ICSI procedure and tests and scans prescribed during the procedure.

In Vitro Fertilization (IVF)

In Vitro Fertilization is a form of assisted reproductive technology. This procedure involves the fusion of an egg and a sperm in a laboratory dish. This procedure is suggested when other less expensive fertility techniques have failed.

Ideal Candidates for IVF

• Progressing age of the woman
• Injured or blocked Fallopian tubes
• Endometriosis
• Male infertility - including reduced sperm count and blockage
• Unexplained infertility

Procedure

The first step of IVF is known as Super ovulation or stimulation. In this step, fertility medications are given to the woman to increase egg production. During this stage, the doctors will advice routine transvaginal ultrasounds to evaluate the ovaries and blood tests to determine hormone levels. In the next stage a minor surgery is done to collect the eggs from the body. This procedure will be performed under anesthesia. The physician inserts fine needle into the ovary and sacs containing the eggs. The needle is attached to a suction device, which separates the eggs and fluid out of each sac, one at a time. The sperm is then fused together with the superior quality eggs. This procedure is termed as insemination. Eggs and sperm are then preserved in an environmentally controlled chamber. The sperm most often enters an egg a few hours after insemination.

Within few days the fertilized egg divides to become an embryo. The embryo is constantly checked to make sure it is growing properly. Embryos are placed into the uterus 3 to 5 days after egg collection and fertilization. This procedure is done as an outpatient procedure while the woman is conscious. The doctor inserts a thin catheter containing the embryos into the vagina, through the cervix, and up into the uterus. If an embryo implants in the lining of the uterus and develops, pregnancy is confirmed. Multiple embryo may be placed into the uterus at the same time, which can lead to twins, triplets, or more. Complete bed rest is not mandatory, unless advised by the doctor. Most women can resume normal activities the next day.

Patients undergoing IVF must take regular injections or tablets of the hormone progesterone for 8 to 10 weeks after the embryo transfer. Progesterone is a hormone produced naturally by the ovaries that helps strengthen the lining of the uterus which makes it easier for the embryo to attach. Adequate progesterone levels during the early weeks of pregnancy may prevent the risk of miscarriage.Know the more information and procedure about Ivf treatment.

Success rate

Success rate of IVF depends on various factors especially the age of the woman undergoing treatment. Women under age 35 are reported to have 41% to 43% success where as for women aged in between 35 to 37 are having a success rate of 33% to 36%.

Cost

The cost of IVF in India ranges from INR 80,000 to INR 250,000 depending on the location, hospital facilities and doctor. Competent doctors having high success rates would charge higher IVF procedure prices.

Difference in a glance

The ICSI is suitable for couples with major male factor infertility. Another significant difference is how the sperm and egg are introduced. In ICSI sperm is injected directly to the egg where as in IVF egg and sperm is allowed to fuse in a petridish. In some cases ICSI is done in addition with IVF in order to ensure better results.