IVF vs ICSI – What is the Difference?

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If you are looking into fertility treatments and In Vitro Fertilization (otherwise known as IVF), then you probably already have some knowledge about what this process is like. IVF helps patients who have trouble conceiving through traditional means or with Intrauterine Insemination (or IUI). IVF allows an egg to be fertilized outside the uterus in a lab. A fertilized egg becomes an embryo and once the embryo reaches a certain stage, it is transplanted into the uterus where it can attach and start growing into a baby.  One way to fertilize the egg is to place it in a dish. Healthy sperm that is collected from the patient’s partner or donor is placed in with the egg, surrounding it. This lets the sperm naturally fertilize the egg by attaching to the outer membrane and pushing through to the cytoplasm. Surrounded by tens of thousands of healthy sperm, there is often a high chance that one will make its way through to the egg and achieve fertilization. 

But sometimes surrounding an egg with sperm does not always work when trying to achieve fertilization and create a healthy embryo. There are several reasons why this can occur, and when it does doctors often turn to Intracytoplasmic Sperm Injection, or ICSI, to solve the problem. 

ICSI can often be the answer to male factor infertility or poor fertilization in previous IVF cycles. It is an extension of IVF, working to control the variables that affect fertilization and increasing the chances of an embryo and a baby. 

A patient may need to seek out ICSI if there are issues with either the sperm or egg. For sperm, this can be because there are too few sperm in a sample. Low sperm count will decrease the chances of one of the sperm successfully breaking through the egg and fertilizing it, making it more difficult to use the more natural process of surrounding an egg with sperm. Difficulties also arise if the sperm have unusual movement patterns. An egg is already hard to break into and these unusual movement patterns can prevent sperm from properly finding or penetrating the egg.

Issues with an egg can often be that it has a very thick outer membrane. Usually, although it is tough, a strong sperm can break through the membrane of an egg to achieve fertilization. But if this membrane is too thick, it can be too difficult for even the healthiest sperm to attach to the egg and fertilize it. Eggs that have been previously frozen can also sometimes present difficulties during the fertilization process. For the most part, if a patient has a history of poor egg fertilization, ICSI will be the next step in achieving fertilization and a healthy embryo. 

So what does the ICSI process entail? The procedure is similar to IVF in that an egg and sperm are retrieved and the egg is then placed in a culture dish. Where this process differs though, is that instead of it being surrounded by sperm in the dish, a single healthy and high-quality sperm is selected and gently injected into the egg with a tiny needle. This allows the sperm to directly access the egg and fertilize it. For an egg with a thick membrane, a sperm no longer has to break through and can fertilize it immediately. If a man has a low sperm count or quality, ICSI creates the ideal opportunity for them to still become fathers to healthy babies. The procedure provides a higher level of control over the quality of the sperm that fertilizes the egg, increasing the chances of a viable embryo and successful pregnancy. 

At Reproductive Health and Wellness Center, we offer IVF, ICSI, and more to ensure that you have every option available and have the highest chances of a successful, healthy pregnancy. If you have been exploring IVF as a further option, schedule a consultation today here to see if ICSI may be the right answer for you!

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