ICSI and IVF, two common ART procedures, share lots of similarities. But these fertility treatments also have one crucial difference, making one method more effective than the other in certain infertility scenarios. Hint: it has to do with fertilization.
For people dealing with infertility, two of the most common treatment options are ICSI (intracytoplasmic sperm injection) and IVF (in vitro fertilization).
Depending on your fertility needs, either method could be the key to conceiving when you need some extra support on your journey to parenthood.
In this comparison of ICSI vs. IVF, we’ll look at what these fertility treatments are, how they work, how effective and safe they are, how much they cost, and whether ICSI or IVF may be right for you.
ICSI vs. IVF: What are these treatments? ICSI and IVF are both forms of assisted reproductive technology, or ART. Fertility treatments with ARTs aim to help you conceive when you’re having difficulty getting pregnant on your own.
With both ICSI and IVF, eggs are fertilized in a lab then the embryo is inserted into the uterus, in the hopes that it implants in the uterine lining and you become pregnant.
ICSI is a more targeted, more specialized form of IVF. To help differentiate between the two procedures, IVF is sometimes referred to as “conventional IVF.”
While ICSI and IVF share many similarities, there’s also one crucial difference.
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ICSI vs. IVF: How do these treatments work? Before we get into the difference between ICSI vs. IVF, it’s helpful to understand how the two treatments work—and how they’re similar.
The ICSI and IVF processes typically start and end the same. Here’s what you can expect:
Sperm collection : Semen is collected, then carefully prepared and analyzed to select the most viable sperm.Fertilization : Eggs are fertilized by sperm in a lab, using two different fertilization methods—this is where ICSI and IVF split!What’s the difference between ICSI vs. IVF? The difference between these two ART procedures comes into play when it’s time to fertilize the egg.
In IVF, fertilizing each egg requires lots of sperm —about 50,000 to 100,000 ! (For context, ejaculate from a normal semen analysis has hundreds of millions of sperm, but someone with fertility issues may have a lower sperm count.)
For each IVF fertilization, the egg and the thousands of sperm cells are placed together in a petri dish and left alone. Then, the sperm fertilize the egg on their own to create an embryo.
In ICSI, on the other hand, fertilization for each egg uses one single sperm
For each ICSI fertilization, the egg is held in place as a single sperm is manually injected directly into the egg to fertilize it . This allows the sperm to easily bypass the egg’s protective barrier, helping it along the journey to form an embryo.
This crucial difference between ICSI vs. IVF fertilization methods is partly what determines which of the two fertility treatments may be right for you.
ICSI vs. IVF: How effective are they? Research shows that ICSI and IVF are similarly effective procedures. With both ICSI and IVF, about 1 in 3 people will get pregnant and have a baby.
Between ICSI vs. IVF, is one better than the other? That depends on your fertility needs.
If you’re dealing with male factor infertility and issues with sperm, for example, the data shows that ICSI has higher pregnancy rates than IVF, making ICSI a better path to parenthood. That’s because of the key difference in fertilization between the two procedures: the one-egg-one-sperm, direct fertilization method used in ICSI is a more effective route for addressing male infertility.
For many other scenarios, IVF on its own may be enough to help you conceive, without needing to add ICSI to your fertility treatment.
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ICSI vs. IVF: Are they safe? Both ICSI and IVF are widely used by people facing infertility. Research indicates that the two procedures are equally safe and overall risks are low.
ICSI and IVF also share the same side effects, as the processes that happen in your body—that is, ovarian stimulation, egg retrieval, and embryo transfer—are the same for both methods.
Side effects of the ICSI and IVF processes include:
Both ICSI and IVF also have a risk of ovarian hyperstimulation syndrome (OHSS), which can require medical attention, and of multiple pregnancies (pregnancies with twins or more).
ICSI vs. IVF: How much do they cost? Many people go through multiple cycles of fertility treatment in order to pregnant. Insurance coverage varies from state to state. In some cases, treatments may not be covered at all.
Before insurance, IVF can cost upwards of $12,000 for a single cycle.
ICSI is an additional procedure done during an IVF cycle, and can cost around an extra $1,500 per cycle on top of IVF base fees.
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ICSI vs. IVF: Which fertility treatment is right for me? Both ICSI and IVF are safe and effective fertility treatments. Choosing between them is a decision that depends on your unique situation and fertility needs.
In many cases, your journey to pregnancy may only call for IVF, without needing to add in the ICSI procedure.
IVF may be right for you if:
You don’t ovulate regularly or don’t ovulate at all You have unexplained infertility (your doctor hasn’t found a particular cause behind your fertility issues) You have a reproductive condition, like endometriosis or PCOS You’re trying to conceive at an older age, like your late 30s or 40s You’re using frozen eggs or frozen sperm Your partner had a vasectomy reversal Sometimes, however, ICSI is necessary for conceiving.
ICSI may be right for you if:
You’re dealing with male factor infertility, including: Low sperm count Sperm that has difficult moving (motility issues) Sperm that’s abnormally shaped (morphology issues) Ejaculation issues You’re using frozen eggs or frozen sperm Your partner had a vasectomy reversal You’ve had multiple unsuccessful IVF cycles Some people may elect to do ICSI even when it isn’t medically necessary, but the American Society of Reproductive Medicine (ASRM) doesn’t recommend this.
Outside of fertility diagnoses that require ICSI (like male factor infertility), data shows that ICSI is as effective as IVF—but it’s more expensive, meaning you may pay more without increasing your chances of a successful pregnancy.
ICSI vs. IVF: What’s the difference? The bottom line ICSI and IVF are both safe and effective ART procedures to help you get pregnant when faced with infertility.
With IVF, the sperm fertilize the eggs on their own. With ICSI, a single sperm is injected directly into an egg to fertilize it. This key difference makes ICSI particularly well-adapted for conceiving when dealing with male factor infertility. In many other cases, IVF on its own may be the key to pregnancy.
Your fertility care team can help you weigh ICSI vs. IVF, so you can choose the best fertility treatment for your needs.
