ICSI - Process and myths | Is ICSI better than IVF ? | Success rate of ICSI

IVF (In Vitro Fertilization), as well as ICSI ( intracytoplasmic sperm injection),are assisted reproductive techniques. However, most patients get foxed by these two terms and confuse one with the other. They aren’t too sure as to which one they should use and what its benefits will be.

Let’s look at each of these to understand what they involve, and how they are different from each other:

The Basic Difference

IVF was the technique that was developed first and ICSI is a variation of this technique. From the viewpoint of a patient, not much changes with reference to scans, superovulation injections, blood tests, egg collection as well as the actual embryo transfer. The only difference is that which takes place in the lab.

>In the IVF process, the sperm are allowed to fertilize the eggs in a Petri dish. ICSI is different in that the embryologist uses a micromanipulator to inject a single sperm inside a single egg. This requires a lot more skill and expertise and experience!

So When is ICSI Used?

As mentioned earlier, in ICSI, the sperm is carefully deposited into the egg- the embryologist selects a good quality sperm and injects it straight into the egg. This method is used when :

IVF vs. ICSI- Busting Some Myths

In the case of male factor infertility, there is no option but to choose ICSI. However, if the man has normal sperm counts, which becomes the better option? It’s at this point that people start contemplating the pros and cons of IVF vs ICSI. Here are some common misunderstandings about ICSI and why they are nothing but that:

  • The truth is that both these treatments have very good success rates; this is primarily because the embryo implantation rates in IVF and ICSI are the same. As long as there is an embryo, it doesn’t really matter whether it has been formed via IVF or ICSI.
  • There are certain clinics that dissuade their patients from doing ICSI as they feel it harms the egg, since the sperm is mechanically introduced into the egg. However, this isn’t the case- As long as the clinic has a skilled embryologist, post ICSI, the egg damage rates are less than 2%.
  • In theory, some IVF specialists believe that in the IVF procedure, only the healthiest sperm fertilize the egg. They also feel that in the case of ICSI, if the embryologist selects a sperm that is abnormal, the embryo will also turn out to be abnormal. But ICSI is a proven treatment and there have been millions of successful ICSI cycles, which disprove this theory.
  • The thing to keep in view is that there is no increase in the risk of birth defects post ICSI. It’s a fact that men who have azoospermia because of Y chromosomal microdeletions and who opt for ICSI will have male offspring with the same microdeletion. However, if a man with normal chromosomes has kids after ICSI, the latter will also have normal chromosomes. The point being made here is that the ICSI procedure itself doesn’t really cause any type of genetic problems.

While the success rates of both these procedures are equally good, at the Malpani Infertility Clinic, when it comes to IVF vs ICSI, we prefer doing the latter. There are a couple of distinct reasons for this:

IVF Vs ICSI- Why ICSI is Better than IVF

In ICSI, the oocytes have to be denuded before the procedure is conducted. This helps us carefully access the quality of the oocyte in greater detail. This is crucial in the case of older women or in those who have poor ovarian reserves.

Also, when we are talking about IVF vs ICSI, there is another major disadvantage of IVF in case of men with normal sperm- some of them have total fertilization failure, which can be a major blow as it’s entirely unexpected. Despite the fact that the motility and sperm count is normal, their sperm can’t fertilize the eggs and this is identified only during the course of IVF. If no embryo is present, the chances of a pregnancy are zilch; and the patient then has to start off on a new IVF cycle with ICSI to ensure that fertilization occurs. By doing ICSI routinely for all patients, we automatically prevent this kind of an issue from cropping up.

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Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.