Home > When to prefer ICSI over IVF

By Priyeta Das, Embryologist on January 25, 2020

In this world full of health concerns and complicated terminologies that tag along with them, the word infertility brings about a fresh bout of anxiety. But now it is possible to know and learn about it more and overcome the dilemma and questions associated with it. Terms such as IUI, IVF, and ICSI might be something infertile couples have been referring to but find it difficult to get a clear idea about them. Here, I hope to explain what ICSI is and to know which treatment option is better for you and also help you get an idea which will make it easier for you to discuss this over with your consultants.

What is ICSI?


Intracytoplasmic Sperm Injection (ICSI) is an assisted reproductive technology (ART) that was developed by a team of embryologists at the Brussels Free University Centre for Reproductive Medicine.
ICSI involves the selection and injection of a single sperm into an egg which, upon successful fertilization, is cultured further to form an embryo that is then transferred to the uterus. The entire process includes a series of steps that I have pointed out in a simplified way for you to understand easily.

Ovarian Stimulation: You are put on a treatment regime so that you produce more number of eggs which will be used for the procedure.

Egg Retrieval: Your eggs will be retrieved with you being under anesthesia.

Sperm preparation: Your partner will be asked for a sample that very day and it will be processed by the semenologist to obtain a clear fraction of good motile sperm

Injection: The embryologist will select the sperms one by one, catch them and inject them into the oocytes.

Embryo Culture: The injected oocytes will be cultured for 5 days post fertilization to grow into blastocysts.

Embryo Transfer: The embryos that successfully form into blastocysts will be transferred into your uterus and the surplus embryos, if any, will be frozen, discarded or donated after obtaining your consent.
The best part about ICSI that makes it more effective than IVF is that it is a very straightforward procedure. Here, maximum importance is given to find the best quality spermatozoa that can be injected into an egg so that fertilization is successful and so that the fertilized eggs go on to produce good quality blastocysts. This also increases the success rate when compared to conventional IVF cycles.

When to opt for the ICSI process over IVF process?
• Patients with poor sperm quality (low sperm count, poor motility)
• Patients with highly abnormal sperm morphology
• Patients with anti-sperm- antibodies in their semen
• Previous IVF failure
• Poor ovarian reserve
• When testicular sperm is to be used for the procedure
• Patients with retrograde ejaculation

Risks involved with ICSI:
• Most of the risks are the same as that of conventional IVF.
• Poor egg quality can lead to damage to some of the eggs as it is an invasive procedure that involves pushing an injecting needle into the egg.
• If very few eggs are retrieved, there is a chance that none of the eggs are suitable for the procedure.
• On rare occasions, there is a chance of fertilization failure where no eggs get fertilized or no embryos form at the end of the culture period.

Any important decisions ever taken involve risks and that’s what makes such situations challenging. One thing you should keep in mind that success is not 100% despite the treatment and procedure chosen. It is the case with options for any fertility treatment, whether it is IUI or IVF or ICSI. But once you have a successful cycle and reap the fruits of your labor, it always will be worth all the pain and effort you have been through.

At Indira IVF and fertility center, our fertility experts are keen to help and resolve all your queries related to infertility or IVF. You can book your appointment for a free consultation now.

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