IVF and ICSI both are Assisted Reproductive Techniques (ART) to help childless couples who cannot conceive a baby naturally. In IVF, the eggs and sperm are mixed together in the laboratory in a dish and the egg is fertilized naturally by the sperm. For this purpose, large numbers of actively swimming normal sperms are required. For many couples, the number of suitable sperms available may be very limited.

There may also be other factors preventing fertilization. So at that time, conventional IVF is not an option and ICSI comes as an alternative. ICSI is very similar to conventional IVF, as it is performed along with IVF. The method of achieving fertilization is the main difference between the two procedures. Now, we will clarify the difference between these two techniques on the basis of various factors:

1. Need for IVF or ICSI

When is IVF Recommended

· Age over Forty

· Blockage or Damage in the fallopian tubes

· Ovulation disorders

· Decided to use donor’s eggs

· Unexplained Infertility

· Uterine Fibroids

· Advanced endometriosis

· Fertility preservation for cancer and other health related issues

When is ICSI Recommended

· In case of low sperm count

· Low mobility of sperm or the sperm cannot move properly

· When sperm has been retrieved surgically from the epididymis (MESA/PESA) or the testes

· In case of high levels of antibodies in the semen

· When there has been a previous fertilization failure using conventional IVF treatment

2. Cost

The cost of ICSI treatment is an added cost with the IVF treatment cost. However, the cost of the treatment depends on many factors like clinic, doctor, ratings, and reviews of the doctor and clinic, location and success rate.

3. Time

Four weeks is the typical amount of time spent in an IVF cycle. It only includes the time after all necessary testing is done. The time spent on a pregnancy test is not added in four weeks. Pregnancy test adds another ten days to two weeks to the timeline.

It almost takes four to six weeks to complete the ICSI first cycle along with IVF treatment. One has to wait for ovaries to respond to the medication and eggs to get matured.

4. Success Rate

The success rate of IVF treatment decreases with age. Women who are more than 35 years old have a 40.7 % success rate and it decreases to only 3.9 % for women who are more than 42 years old. Apart from this the success rate also depends on other factors like reproductive history, the cause of infertility, and lifestyle factors.

ICSI is used with conventional IVF to increase the success rate. The success rate of ICSI also depends on age. With a young age, there are more chances of ICSI treatment to be successful. The success rate is 44 % for women of age between 18 to 35 years. It goes on decreasing and be just 11 % for the age group between 43 to 45 years old.

Facts About ICSI and IVF

In the case of male infertility, there is no option but to choose ICSI. However, if the man has normal sperm counts, then IVF is a better choice. Here are some of the facts to be considered before going for ICSI or IVF treatment:

· There is a misconception that through IVF treatment twins or triplets are born. However, the majority of women who go through the IVF treatment have a single child.

· According to research, only 21% of pregnancies through IVF or ICSI result in twins and 1% results in triplets. This happens due to the process of transferring multiple embryos to increase the chances of pregnancy.

· There are certain clinics that prevent their patients from doing ICSI. As they believe that it harms the egg since the sperm is mechanically introduced into the egg. However, this is not true, as long as the clinic has a skilled embryologist.

· There is no increase in the risk of birth defects post ICSI treatment and ICSI procedure does not cause any type of genetic problems.

Reasons to Choose ICSI or IVF

While the success rates of both these procedures are equally good, but when it comes to IVF versus ICSI, clinics and doctors’ prefer doing the latter.

When we are talking about IVF versus ICSI, there is a major disadvantage of IVF. In the case of men who have normal sperm, some of them may have total fertilization failure, which can be a major blow as it is entirely unexpected.

In the case of IVF, despite the fact that the motility and sperm count is normal, sometimes the sperm does not fertilize the egg and this is identified only during the course of IVF. At that time, the patient then has to start off on a new IVF cycle with ICSI to ensure that fertilization occurs.