IVF, ICSI, IUI, Male & Female Infertility Treatments
What is IVF
IVF stands for in vitro fertilization, which literally means “in lab conception.” With IVF treatment, the egg is fertilized with sperm in a petri dish. Typically, many eggs are retrieved from the biological mother (who may or may not be the intended parent), as not every egg will fertilize, and not every fertilized egg will become a viable embryo.
A few days after fertilization, the best embryo or embryos are transferred to the mother or surrogate’s uterus via a catheter through the cervix. Any extra embryos may be cryopreserved for future cycles.
Different types of fertility Treatment
The IVF procedure may be slightly different for different people, depending on which assisted reproductive technologies are being used and whether or not donor eggs, sperm, or embryos are involved. There are also some situations that lead to a cycle being cancelled in the middle, either because not enough follicles grow or due to a high risk of serious ovarian hyperstimulation syndrome (OHSS).That said, this is a basic overview of the procedure.
Usually, the woman will start taking birth control pills or an injectable medication that prevents ovulation the cycle before treatment, shutting down the woman’s normal ovulation cycle. This is so the doctor can regulate ovulation and not lose the eggs before the retrieval.
After baseline blood work and an ultrasound, the woman will start taking ovulation stimulation medications, typically gonadotropins. In minimal stimulation IVF, clomid or no ovulation stimulating medications are used, but this is unusual. The clinic will monitor follicle growth and hormone levels with ultrasound and blood work every so many days. When the follicles look ready, the woman will receive an injection of hCG to mature the eggs. An egg retrieval will be scheduled a very specific number of hours after the injection, during which the woman will receive IV sedation and the eggs will be retrieved via an ultrasound guided needle through the vaginal wall.
While the woman is having the egg retrieval, the man will be providing the semen sample. Sometimes this is done once at the retrieval and also sometime before retrieval day (and frozen), in case of problems or anxiety creating the sample. The semen will go through a special washing procedure, and the eggs will be placed in a special culture. The sperm will be placed with the eggs, in hopes that fertilization will take place.
A few days later, an embryologist will help select the healthiest of the fertilized embryos, if any, and your fertility doctor will help decide how many embryos to transfer. Leftover embryos may be cryopreserved for a later cycle, donated to another couple, or thrown away.
What is ICSI
Intracytoplasmic sperm injection (ICSI) can be used as part of an in vitro fertilisation (IVF) treatment to help you and your spouse to conceive a child. ICSI is the most successful form of treatment for men who are infertile and is used in nearly half of all IVF treatments.
ICSI only requires one sperm, which is injected directly into the egg. The fertilised egg (embryo) is then transferred to your uterus (womb).
One cycle of ICSI takes between four weeks and six weeks to complete. You and your spouse can expect to spend a full day at the clinic for the egg and sperm retrieval procedures. You’ll go back anywhere between two days and six days later for the embryo transfer procedure.
ICSI is likely to be recommended if your spouse has:
• A very low or zero sperm count.
• A high percentage of abnormally shaped sperm. This can result in poor motility, which means the sperm can’t swim well.
• Sperm that can’t be ejaculated but can be collected from the testicles or from the duct where sperm is stored (epididymis). This may be needed if your spouse has had an irreversible vasectomy or injury.
• Problems with getting an erection and ejaculating, due to spinal cord injuries or diabetes, for example.
If you have tried IVF you may move on to ICSI if not enough eggs could be retrieved, or if eggs retrieved for IVF were not successfully fertilised.
What is IUI
Intrauterine insemination (IUI) is a form of assisted conception. During IUI, your doctor will place washed, prepared sperm into your uterus (womb) and near to your egg at your time of ovulation. This procedure is often combined with fertility drugs to increase your chances of conceiving.
The insemination itself is straightforward and takes only a few minutes. If you are having a stimulated cycle, you’ll need to take fertility drugs before you ovulate.
IUI, or intrauterine insemination, is a relatively simple infertility treatment, where a small tube is used to place specially washed sperm directly into the uterus. You may know of IUI by the more commonly used term artificial insemination (AI). IUI and AI are one and the same fertility treatment.