What is the difference between IVF and ICSI?

If you’re interested in fertility or considering undergoing fertility treatment, it is more than likely you’ll have heard of in vitro fertilisation (IVF). What is less common knowledge is the technique of intracytoplasmic sperm injection (ICSI), used to aid successful egg fertilisation.

Here, we’ve shared everything you need to know about IVF and ICSI including the key differences and when one might be recommended over the other.   

Understanding IVF

Today, IVF is one of the most common and successful fertility treatments. 

The procedure involves retrieving female eggs from the ovaries and fertilising them with sperm in an embryology laboratory. The embryos created are then transferred back into the uterus with the hope of successful implantation.  

How does it work?

During conventional IVF, a course of hormonal medications is given to stimulate growth of multiple eggs. The mature eggs are collected directly from the female’s ovaries for use in treatment. The collected eggs are then mixed with sperm and left so that the best sperm fertilizes each egg.  

The fertilised egg/s develop into embryos which are cultured in a lab for 5-6 days until they reach the blastocyst stage. The healthiest embryo is selected for transfer into the uterus. Any remaining healthy embryos can be frozen and stored for use in future treatment. 

If you have no eggs or egg quality is poor, you can use donated eggs as part of your IVF cycle. You can also use sperm from a partner or co-parent or sperm from a donor.  

Who is IVF suitable for? 

IVF treatment could be a good option for you if: 

• You’re a couple that has been unable to conceive because of an identified fertility problem e.g. blockage of the fallopian tubes, PCOS or endometriosis.  

• You’re a couple where a no infertility cause has been found i.e. unexplained infertility. 

• You’re an older female whose ovarian reserve (number of eggs) has declined with age making natural conception more difficult  

• You’ve already tried other types of treatment, for example, IUI, that have been unsuccessful 

• You’re a lesbian or same-sex female couple 

• You’re a single woman pursuing solo parenthood using donor sperm 

Understanding ICSI

ICSI is an extra procedure carried out during conventional IVF treatment where a single healthy sperm is selected by an embryologist and injected directly into the egg. This can increase the chance of fertilisation as the sperm no longer has the challenge of penetrating the egg cell wall on its own.  

When is ICSI used?

ICSI may be recommended by a fertility specialist if: 

• The male partner has a low sperm count  

• The male partner’s sperm does not move normally or are abnormally shaped  

• The sperm has been recovered by a surgical sperm retrieval  

• The sperm has high levels of DNA damage  

• You’ve gone through conventional IVF previously and none or very few eggs were fertilised 

• You’re using donor eggs  

• You’re using frozen eggs or sperm 

Comparing cost

As the ICSI procedure is more skilled and complex, the cost is added to the cost of a conventional IVF cycle.  

At TFP Fertility, a typical IVF cycle costs £6295 which includes egg collection and a fresh embryo transfer. If you opt to have ICSI as an add-on procedure, the cost of this is an additional £1265.  

It’s important to know that every treatment plan is personalised and therefore, the complete cost will vary patient to patient. Your TFP fertility doctor and patient support team will be able to explain the costs of your tailor-made treatment. 

Visit your local TFP Fertility clinic page for more information on our pricing, treatment packages and the payment options available.  

How to choose between IVF and ICSI

ICSI is recommended in cases where male factor fertility challenges are being experienced, for example, a low sperm count or poor motility or morphology.  

The procedure is also necessary when a woman has chosen to preserve her fertility by freezing her eggs, either for medical or social reasons. This is because the vitrification (freezing) process, while harmless and effective, hardens the cell wall making it harder for sperm to penetrate it on their own.