ICSI vs IVF: What’s the Difference?

Choosing the right fertility treatment can feel overwhelming when there feels so much at stake. Both In-Vitro Fertilisation (IVF) and Intra-Cytoplasmic Sperm Injection (ICSI) treatments aim to help you achieve pregnancy, but they differ in processes, costs, risks, and success rates. This guide will help you understand the key differences between IVF and ICSI.

Introduction to IVF and ICSI

IVF and ICSI are advanced fertility treatments that assist in conception. For some people IVF alone is suitable, whereas others will require ICSI to maximise the chances of a successful pregnancy. Let’s break down each treatment and what they entail. 

For more information on fertility treatments, check out our IVF package and IVF with ICSI options.

The Process: IVF vs ICSI

What is the IVF Process

IVF involves several steps to assist with fertilisation:

1. Ovarian Stimulation: Medications stimulate the ovaries to produce multiple eggs.

2. Egg Retrieval: Eggs are collected from the ovaries through a minor surgical procedure.

3. Fertilisation: Eggs and sperm are combined in a lab dish to allow fertilisation.

4. Embryo Culture: Fertilised eggs (embryos) are cultured for a few days.

5. Embryo Transfer: One or more embryos are transferred to the uterus.

What is the ICSI process? 

ICSI is a specialised treatment and is often combined with an IVF cycle with an additional step to increase chances of fertilisation: 

1. Ovarian Stimulation: Similar to IVF, medications stimulate the ovaries.

2. Egg Retrieval: Eggs are collected from the ovaries.

3. Sperm Injection: A single sperm is injected directly into each mature egg using a fine needle. This takes place in the lab by a highly trained Embryologist.

4. Embryo Culture: The injected eggs (embryos) are cultured.

5. Embryo Transfer: One or more embryos are transferred to the uterus.

Is ICSI more expensive than IVF? 

How much does IVF cost?

In the UK, the average cost for one round of IVF for a heterosexual couple, including fertility tests for both partners and all of the medication is £7,454 (before add ons which can vary from person to person). This is significantly higher than the advertised prices, so when you speak to a clinic, make sure you get all information about what’s included in the package.

How much does ICSI cost? 

The IVF with ICSI procedure is slightly more expensive than standard IVF due to the additional laboratory work involved. The cost typically ranges from £4,000 to £6,000 per cycle, however again that doesn’t include any of the tests, consultations or medications and other related expenses which mean the actual cost is closer to £8000-£10,000.

Are there any risks with IVF and ICSI? 

IVF Risks

• Multiple Pregnancies: when more than one embryo is transferred, this increases the chance of twins or more.

• Ovarian Hyperstimulation Syndrome (OHSS): this is a rare reaction to fertility drugs.

• Surgical Risks: Minimal risks associated with egg retrieval.

ICSI Risks

• Multiple Pregnancies: Similar to IVF, transferring multiple embryos can lead to multiples.

• Surgical Risks: Related to egg retrieval, just as in IVF.

Pros and Cons: IVF vs ICSI

IVF Pros

• Less Invasive Fertilisation: Eggs and sperm are combined in a dish without direct injection.

• Lower Cost: Slightly less expensive than ICSI.

• Broad Applicability: Suitable for a wide range of fertility issues.

IVF Cons

• Fertilisation Uncertainty: There's a chance that eggs and sperm might not fertilise.

Pros of ICSI 

• High Fertilisation Rate: Direct injection of sperm increases the chances of fertilisation, especially with severe male infertility.

• Effective for Severe Cases: Ideal for couples with significant sperm issues.

• Controlled Process: The lab process allows for precise fertilisation.

Are there any cons with ICSI? 

• More expensive due to the additional work in the lab with the embryology team. Only eggs that meet certain maturity levels can be used for an ICSI procedure. And not every egg can withstand the injection process of ICSI, so there is a higher risk of creating less embryos. 

• There are certain risks associated with ICSI including certain genetic and developmental defects in a very small number of children born using this treatment; however, problems that have been linked with ICSI may have been caused by the underlying infertility, rather than the treatment itself.

Success Rates: IVF vs ICSI

IVF success rates vary based on age and specific fertility issues. The below success rates are based on the national average in the UK. At Apricity our success rates are significantly above the national average for both own and donor eggs. Read more about our success rates. 

• Women under 35: Approximately 40-45% per cycle.

• Women 35-40: Around 30-35% per cycle.

• Women over 40: About 15-20% per cycle.

ICSI has similar success rates to IVF, as it primarily improves fertilisation rates rather than implantation:

• Women under 35: Approximately 40-45% per cycle.

• Women 35-40: Around 30-35% per cycle.

• Women over 40: About 15-20% per cycle.

Should you have IVF or IVF & ICSI? 

IVF is recommended for:

• Women with blocked or damaged fallopian tubes.

• Couples with unexplained infertility.

• Women with ovulation disorders.

• Couples who have not had success with other treatments like IUI.

ICSI is particularly beneficial for:

• Men with very low sperm count or poor sperm motility.

• Couples with previous fertilisation failure using standard IVF.

• Cases of sperm retrieved directly from the testicles.

Commonly asked questions we hear at the clinic: 

Which is better, IVF or ICSI?

Neither is inherently better; as it depends on your specific fertility issues and diagnosis. ICSI is often better for severe male infertility, while standard IVF is effective for a broader range of issues.

What is the downside of ICSI?

The main downsides of ICSI include higher costs and a slightly increased risk of certain birth defects, although these risks are still relatively low. 

Is ICSI more expensive than IVF?

Yes, ICSI is generally more expensive than IVF  due to the additional laboratory work involved when an embryologist directly injects the sperm into the egg.

Is ICSI more successful?

ICSI can increase the chances of fertilisation, particularly in cases of severe male infertility, but overall pregnancy success rates are similar to those of standard IVF.

Conclusion

ICSI is an additional step to aid fertilisation in an IVF cycle, and your doctor will help you make the decision on whether you need to include an ICSI procedure in your treatment, and this depends on your specific fertility issues and needs. Asking the questions to help you understand the processes, costs, risks, and success rates can help guide your decision.

For more detailed information, explore our IVF package, IVF with ICSI, and our insights on IVF success rates by age.