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IVF or ICSI? What is the right fertility treatment?

Dr Uma Gordon, consultant gynaecologist, and specialist in reproductive medicine and surgery. She is also the Clinical Director of Bristol Fertility Clinic.

Sometimes I have a couple coming to me and saying they want to proceed for ICSI, but they may not have an indication to proceed for ISCI.

So I thought this video will outline the differences between IVF and ICSI and when do we use each one of those.

ICSI is used for male factor problems, where we select a single sperm and inject it into the egg and it's called intracytoplasmic sperm injection, into the cytoplasm of the egg, sperm injection.

It's a micromanipulation technique, sometimes known as advanced IVF.

IVF in itself, is where we put an egg with several thousand sperm, 50 to a hundred thousand sperm and it's known as conventional IVF or otherwise known as test-tube baby technology.

And conventional IVF is used for female factors, whether it's unexplained, where the ovulation is not happening and medical treatments haven't worked, tubal problem, et cetera, whereas ICSI, is for malefactor.

There are several studies that have been done, especially all over the world, but particularly also in the UK, where they have shown that using ICSI for all does not give any benefit.

And these studies have also shown that using ICSI without any rationale or without an appropriate diagnosis, is not helpful, but can be detrimental.

Why? Because ICSI is much more expensive and ICSI also has implications for the children born.

And these aspects need to be covered by the clinic before you proceed with treatment.

So when you come for an initial consultation to proceed with assisted reproduction treatment, an appropriate diagnosis has to be made.

What is your diagnosis?

Why are we offering assisted reproduction treatment?

And then depending upon your condition, we will be directing you towards IVF or ICSI treatment.

With ICSI there are implications in that if you have 10 eggs and only seven are mature, we only inject the mature eggs.

By law in the UK, you can only inject mature eggs.

With IVF as the eggs are maturing, the sperm can get in, so there is that difference as well, that you need to be aware of.

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