Which ART Treatment Works Best for You
Most couples may feel perplexed by the sheer number of options currently available as infertility treatments. To plan a successful pregnancy, you may find it helpful to acquaint yourself with the purpose, pros and cons, and success rates of the most popular ART treatment procedures.
Your physician is most likely to recommend IUI, IVF or ICSI procedures to address concerns related to male or female infertility, whichever be the case. Although every procedure is designed to achieve artificial insemination, the method and result are different in each case.
What are the Three Most Popular Procedures to Treat Infertility?
Intrauterine Sperm Insemination (IUI)
Ovarian stimulation procedure may be done in combination with the IUI to increase chances of success. An IUI is normally recommended when there is unexplained infertility or in cases where there is no significant male factor. Success rates of an IUI procedure vary based on age of the couple, number of IUI cycles and other factors but on average is between 15-20%.
In-Vitro Fertilization (IVF)
There may be instances when an IUI treatment may not be the best option for the couple, especially in cases where the sperm count is low or when the sperms have poor motility. Another very important but often neglected cause of failed IUI treatments is poor sperm DNA integrity. Many published studies have established that if sperm DFI values are above a certain level, this decreases the success of an IUI and couples are more likely to achieve success by moving to treatments like IVF or ICSI. An IVF procedure involves harvesting the oocytes from the female partner after a hormone stimulation procedure and the retrieval of sperms from the male partner by ejaculation or surgical retrieval methods. The oocytes and sperm are then placed in an enriched media in favourable conditions in a temperature controlled incubator. Fertilization occurs and the newly formed embryos are monitored regularly and allowed to develop and grow to a certain stage. In most cases, either the day 3 or day 5 embryo (blastocyst) is transferred to into the uterine cavity for implantation. AN IVF is recommended in cases of unexplained or idiopathic infertility, mild male factor cases and cases where there are tubal blockages or damage. The average success rate of IVF is about 20-35% where age has a major impact on the results of IVF. The success rate among women less than 35 years of age is about 35- 40%.
Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic Sperm Injection (ICSI) is the process of injecting the sperm into the mature oocyte of the female partner artificially. After ovarian stimulation and oocyte retrieval procedures, sperm is collected either by ejaculation or surgical retrieval methods.
This procedure has higher chances of fertilization even when problems with sperm count or motility prevent it from swimming toward the oocyte and entering through its cell wall. Direct injection of the sperm into the oocyte eliminates the need for the sperm to travel all the way to the fallopian tube to pierce through the cell wall of the oocyte. An ICSI procedure is helpful in severe male infertility cases or when there is high sperm DNA fragmentation and is accompanied by a fairly good success rate. It also allows maximum control over the different variables involved in the fertilization process.
Which Procedure is best for you?
Choosing the best fertility treatment, depends on the causes of the Infertility and other factors such as age and financial circumstances. In general, if you are facing issues with the fertilization happening inside the body, the IVF procedure is most likely to work in your favor. IVF and ICSI also helps eliminate the underlying problem when its nature is unknown. Another advantage is that these lab procedures result in the production of multiple embryos in some cases which can be used during one ART cycle or can also be frozen and used at a later date.
ICSI is generally recommended by most specialists when the sperm DNA is damaged to an extent which cannot be repaired with any lifestyle changes or antioxidants, and when its count and motility is lower than normal. Artificially injecting the sperm enter into the oocyte of the female partner increases chances of a successful pregnancy even when multiple issues exist with the sperm.
In IUI or Intrauterine Insemination, the sperm of the male partner or a donor is injected through a catheter into the uterus of the woman when ovulation takes place. Timing is crucial as it helps increase chances of successful fertilization of the oocyte. It is the simplest among all procedures and is minimally invasive.
What should you consider before the Final Decision?
IUI, IVF, and ICSI have their own advantages and downsides. A certain procedure may result in a high success rate for one couple, and a completely different outcome for another. Your Infertility specialist is likely to consider background information such as your age, medical history and response to infertility procedures undertaken so far before choosing the best option for you.
Furthermore, the nature of executing the procedure also matters for most couples. You may want to consider how invasive the procedure is to understand what to expect while undergoing the fertility treatment. In this context, while IUI and ICSI are invasive to a greater degree, IVF is only minimally invasive, precisely at the time of harvesting the oocyte.
In most cases, your physician’s advice is based on the nature of the sperm including its count, motility, quality, and the ovulation cycle of the female partner among other factors. Most specialists aim for the least invasive option. But if the factors associated with the sperm and oocyte are not in favor of a natural fertilization process, artificial insemination through the ICSI or IVF is chosen to increase chances of success.
