Many families today are faced with a rather difficult diagnosis - "infertility". It can be due to the presence of a married couple of some health problems, defects of the reproductive system and many other factors. Some of them are successfully treated, and the spouses become happy parents of a long-awaited child. But what about men and women who have absolute infertility, when there is not a single, even the slightest chance to have a baby naturally? Today, medical scientists are constantly working on the problems of infertility, including absolute. For this reason, people with infertility now have the opportunity to undergo certain procedures that will help achieve a long-awaited pregnancy. All of them belong to the group of ART or assisted reproductive technologies. Modern medicine can offer the following means for therapy and victory over the diagnosis of infertility: IVF, ICSI, IMSI, PGD, PICSI.

Of course, not everyone understands what lies under all the letters, so incomprehensible at first glance. In this article, we will decipher their meaning, discuss each of the methods separately, find out which one is more effective, and in general How is ICSI different from IVF? and other methods.

To date, the most common method of assisted reproductive technology is IVF or in vitro fertilization. Its essence lies in the fact that mature oocytes are extracted from the female ovaries, and sperm is donated by the partner. In specially created laboratory conditions, the sex cells of a woman and a man are combined, as a result of which fertilization is carried out. The difference from natural fertilization, that is, inside the female body, lies only in the fact that no negative extraneous factors exert any influence on it, which, probably, were the reason for the inability to conceive in the traditional way.

When the spermatozoon manages to carry out fertilization, and the egg begins to divide, turning into an embryo, it is placed in a specially created cultural environment for further growth and development. A few days later, the already developed embryo is transferred to the previously prepared uterine cavity of the patient, where it will need to attach to the endometrial wall in order to begin its development already in the mother's body. If the embryo transfer was successful, a pregnancy ensues that is virtually indistinguishable from a pregnancy that was achieved naturally.

Methods are also used to help increase efficiency. ECO.

ICSI is a method of injecting sperm into the cytoplasm of the oocyte

Many are interested in the question: which is better IVF or ICSI? Let's figure it out. When IVF is performed in conjunction with ICSI, the fertilization of the oocyte by accidental sperm is completely excluded. The strongest and healthiest representative is selected in advance by the embryologist, then, using a special microscopic needle, it is injected directly into the oocyte. It turns out that difference between IVF and ICSI lies in the fact that the usual in vitro fertilization takes place with a random sperm, and in the second situation, fertilization takes place under the full control of a specialist. This method is usually applied in case of poor quality of male sperm. And the question is which IVF and ICSI difference, is incorrect, since the second method is used to increase the efficiency of the first.

IMSI - ICSI MAX with additional sperm diagnostics

Main difference ICSI from IMSI lies in the fact that in the second case, a more thorough process of selection and analysis of sperm is performed for further fertilization of the egg. In the laboratory, the embryologist performs screening using a special microscope with 6000x magnification. In comparison, when using ICSI technology, the spermatozoon is selected from the total mass using a microscope with a four hundredfold magnification. the main objective ECO ICSI IMSI is not just to select the most mobile spermatozoon, but also to evaluate its structure and morphological qualities. Therefore, this method is more efficient.

PICSI - ICSI , in which an additional study is carried out for maturity

The essence of the PICSI method lies in the fact that with standard ICSI, after selecting the most suitable sperm, the reproductive embryologist checks them for maturity. Visually, even in the case of using microscopes with multiple magnification, it is simply impossible to determine the level of maturity of spermatozoa. For this reason, when using the method ECO ICSI PIXY Selected sperm are placed in a test tube filled with hyaluronic acid. According to recent studies, the spermatozoa that have reached the mature phase and have the least amount of DNA damage begin to interact with the acid. The most mature one, which has a good morphological structure and, based on this, a more suitable spermatozoon stands out favorably from the others and is selected for further ICSI. The PICSI technique can be used in combination with the IMSI method.

PGD ​​- preimplantation genetic diagnosis

This check is made for the embryo that will be transferred into the uterine cavity. At a certain stage of embryonic development, a single cell is cleaved off, which is subjected to a check for the presence of any genetic abnormalities. PGD ​​analysis is not recommended for every couple undergoing in vitro fertilization, but only for those who have a fairly high probability of having a child with genetic defects or some serious disease (usually this is due to hereditary or age factors). The test makes it possible to prevent the birth of a baby suffering from a disease such as, for example, Down syndrome.

Due to the fact that diagnostics is carried out on the fetus, more precisely, on an already born person, for ethical reasons, the PGD technique is prohibited in many countries of the world.

TESA - in the absence of spermatozoa in the ejaculate

TESA - ICSI, in which the spermatozoa required for injection into the oocyte are removed from the testicle by puncture. After taking a certain number of samples, tissues taken from the epididymis are placed in a special environment in which the spermatozoa are separated from other tissues.

Which ART method to choose?

Usually spouses do not need to ask this question. A competent reproductologist will talk about the likely options and offer the most effective technique for specific patients already at one of the first consultations. Regardless of how it will be decided to choose cells for fertilization, this will not change anything for a married couple, since all diagnostic and analytical procedures are carried out in the laboratory without their participation.

Therefore, if you decide to conceive a child through ART, you should not think about How is ICSI different from IMSI? and other methods. If you fully trust your doctor and are sure that he will do everything possible so that you can still become parents, it should not matter to you which of the methods he considers the most effective. Faith in success and luck will help you overcome all difficulties and achieve your goal.

The abbreviation IVF is familiar and familiar even to those who have not personally encountered assisted reproductive technologies. But ICSI is perceived as something new, complex and obscure. What is the difference between ICSI and IVF, infertile women and men are interested in choosing the method of artificial insemination.

If you take it superficially, then the difference between the manipulations is insignificant. Both procedures have the same goal - pregnancy. Preparation for both interventions is carried out with hormonal preparations. Fertilization also occurs in the same way - in artificial conditions. However, there are still differences between the manipulations.

What is the difference between IVF and ICSI?

In vitro fertilization is an assisted reproductive technology method that involves the introduction of spermatozoa into the egg in the laboratory, followed by the transfer of the resulting embryos into the uterine cavity.

The ICSI procedure is a variant of IVF, but in this case, special conditions are met. The technique got its name from the phrase IntraCytoplasmic Sperm Injection, which means intracytoplasmic sperm injection (ICSI). The procedure was created for the treatment of infertility of various origins in married couples.

A significant difference between IVF and ICSI is the cost of manipulations. Standard in vitro fertilization is considered less expensive than the procedure using intracytoplasmic injection technology. This difference is fundamental for the patient and her partner. Otherwise, traditional IVF and IVF with ICSI are identical for them.

The main burden during additional manipulation (ICSI) falls on the shoulders of laboratory assistants and embryologists. For experts, the difference between these methods is significant. The main difference lies in the process of fertilization. In conventional IVF, spermatozoa are combined with an egg in a test tube and enter it on their own. Intracytoplasmic injection involves the manual introduction of male sperm into the female germ cell.

The selection of spermatozoa for fertilization is also done in different ways.

It should be noted that the ICSI method for IVF is applied on the basis of certain conditions, and not at the request of the couple. Therefore, when preparing for a free procedure of assisted reproductive technologies, patients do not have to choose the method of its implementation. Doctors will do it for them.

Indications for fertilization by ICSI

The ICSI procedure for IVF is performed if a man has indications for this. Pathological conditions are detected during the study of spermogram. The most common abnormalities that are the basis for the use of intracytoplasmic injection into the egg are:

• oligozoospermia - a decrease in the quantitative composition of spermatozoa (if less than 10 million cells are found in 1 ml of ejaculant);
• asthenozoospermia - lack of sperm activity (often combined with oligozoospermia).

A bad spermogram, the state of which can be brought back to normal with drugs, is not a reason for performing an injection into the egg. For the ICSI procedure, indications are limited to the following list:

• a poor history of fertilized cells and the ineffectiveness of alternative IVF methods;
• male infertility due to a violation of the structure of sperm;
• a decrease in the quantity and quality of genetic material in a man;
• poor condition of sperm after thawing;
• immune factor of infertility (presence of antisperm antibodies);
• the need to perform PGD (pre-implantation diagnosis) in order to prevent the occurrence of genetic disorders in the fetus of a certain gender.

It is generally accepted that indications for ICSI are only male disorders. However, for every rule there is an exception. So, for example, when obtaining a single egg in a natural cycle or when performing IVF in a cryoprotocol with poor quality of thawed material, it is advisable to carry out an intracytoplasmic injection to increase the likelihood of a favorable result. Each case is individual, as is the body of both partners. The need for ICSI is determined during preliminary diagnostics in preparation for IVF.

How is ICSI done?

If the ICSI program is included in the in vitro fertilization protocol, then the work of embryologists and reproductologists becomes more complicated. In the process of a standard protocol, the combination of spermatozoa with eggs takes place in one tube. Nature and natural selection determine better male cells, which later merge with mature oocytes.

ICSI involves the same manipulations until the collection of genetic material. At this stage, all processes occurring outside the patient's body are thoroughly controlled by the doctor.

1. A detailed assessment of the condition of the collected eggs is carried out. The embryologist does not have the opportunity to look inside and reliably examine the condition, selecting the best one. However, in appearance (the integrity of the membrane and its shape, the presence and absence of inclusions, the definition of vacuoles and granularity), one can assume the result of fertilization. For the procedure, the best of the available gametes is selected.
2. Selected mature oocytes are placed in a Petri dish. After that, they are placed in a special incubator, where carbon dioxide is located, and the ambient temperature is 37 degrees. These conditions fully reproduce the state of the female body. Over the next few hours, the cells should "rest".
3. At this time, semen is taken. Valuable genetic material is about 3% of the total volume of the ejaculant. Therefore, the main task of embryologists and laboratory assistants is to purify spermatozoa, screen out impurities and select the highest quality cell. For this, different solutions with different densities are used and centrifugation is carried out. In the process of manipulation, it becomes possible to select only mobile and healthy cells.
4. After choosing the highest quality sperm, it is processed and the tail is cut off. This is a prerequisite, since during natural conception the tail does not enter the egg, which reduces the likelihood of defects in the embryo. Holding the egg with a special microscopic pipette, a special needle punctures the membrane and introduces the sperm head. At this stage, the features of the ICSI procedure are completed.

During the next day (from 3 to 5), the cells are in the incubator under the supervision of embryologists. The transfer of the resulting embryos is scheduled for a specific day and involves the standard preparation of the patient, as in the usual IVF.

In the natural cycle

IVF with ICSI in the natural cycle is performed when the patient is contraindicated for stimulation or cannot take hormonal drugs due to comorbidities. In such a situation, careful monitoring of the maturation of the follicle is carried out so that premature ovulation does not occur. If a man has no problems with the quality of seminal fluid, and a woman has only one egg in the EC (natural cycle), then this is not an indication for the procedure.

There are clinics where you can pay extra for ICSI in the absence of indications.

With stimulation

Preparation for ICSI begins at the end of the past or the beginning of the present menstrual cycle of a woman. Previously, the patient goes through a list of necessary tests and receives advice from recommended specialists. The start date of hormonal stimulation is determined in accordance with the type of protocol. Usually short or long are used, other types of IVF are used less frequently. With the help of drugs, the level of sex hormones is regulated, as a result of which several follicles mature. Having reached the required size, they are punctured. Further actions involve the implementation of the intracytoplasmic injection algorithm.

IVF or ICSI: which is more likely?

About what is better - IVF or ICSI - you can talk endlessly. Patient reviews are very different. Some women talk about the fact that you can get pregnant with conventional IVF, and the procedure will be much cheaper. Others argue that it is the intracytoplasmic egg injection that increases the effectiveness of the method of assisted reproductive technologies. In reality, there are pros and cons to both methods of infertility treatment.

As you know, ICSI is a method that allows fertilization when the seminal fluid of the partner is of poor quality. With the natural mixing of female oocytes and the genetic material of a man, conception will probably not occur. For this reason, the ICSI technique can be called the only chance for a favorable outcome. Indeed, in the process of sifting sperm, the best cells are selected. This greatly increases the chances of successful fertilization. This means that the assisted manual fertilization technique has a high probability of a good result.

ICSI children - what are they?

Pregnancy after ICSI occurs as often as during IVF. With manual fertilization, the probability of successful cell fusion is higher than with standard IVF. However, the percentage of embryo survival remains the same. An important role is played by the state of the woman's endometrium, her hormonal background, the correctness of the selected drugs for support. Concomitant factors also regulate the gestation process.

As for the health of a child born after ICSI, the opinions of experts on this matter again diverge. It is assumed that after ICSI children are stronger. They are conceived from the best cells of the male and female body. At the same time, additional pre-implantation diagnostics promises the birth of a baby without any hereditary genetic anomalies. The ICSI method can be considered the highest chance of having an ideal offspring. However, there is a downside to this process.

The intracytoplasmic injection procedure for performing mechanical insemination is prescribed for certain indications. Couples with “bad” genetic material or immune infertility are forced to resort to this method of treating infertility. Although the best spermatozoa are selected for the procedure, they may be weak.

For this reason, there is always a risk of the patient giving birth to a child with abnormalities. Despite the possibilities of modern medicine, the methods of assisted reproductive technologies have not yet been thoroughly studied. Reproductologists who perform the ICSI procedure for IVF can only talk about the percentage of one or another result, but are not able to guarantee the birth of an absolutely healthy child. However, natural conception does not provide such a guarantee.

How much does ICSI cost?

The intracytoplasmic injection procedure can be carried out free of charge, according to compulsory medical insurance, but only if the man has the appropriate indications. At the same time, a woman's state of health does not affect the likelihood of obtaining a quota for ICSI. Each region has certain rules and indications that provide for the appointment of this procedure.

The cost of ICSI can be paid separately by the couple if they were only given an IVF quota and were not approved for the injection. The price category of this type of treatment has a wide range, the starting point of which is the rate of 25 thousand Russian rubles. If it is necessary to carry out additional manipulations with spermatozoa and eggs, the price increases.

The price of ICSI together with IVF in a private clinic (not under the MHI policy) starts from 120 thousand rubles. The main part of the cost of treatment will be in vitro fertilization. In the natural cycle, it will cost at least 90 thousand rubles (excluding the cost of drugs), and with stimulation, the price will tend to 200 thousand.

Pre-implantation diagnostics, performed at the request of patients, will range from 40 to 250 thousand Russian rubles.

ICSI in the IVF procedure allows a couple with male infertility to become pregnant. The procedure shows its effectiveness even with fusion of the vas deferens and after vasectomy in men.

The problem of infertility worries many women. Modern medicine offers a revolutionary approach to solving the problem of conception with the help of new technologies - IVF and ICSI. However, few of the couples understand what the meaning of the method of these technologies is, and which one is preferable. Let us consider in detail what is the difference between eco and ixi.

In vitro conception is a modern method of fertilizing an egg outside a woman's body. To do this, several eggs are removed at once. The difference between ICSI and IVF is the method of pre-treatment of the spermatozoon before introduction into the egg. In the case of IVF, natural untreated spermatozoa are used.

The further medical procedure is the same for both methods - the embryo is placed in the uterus for subsequent development in vivo. Specialists correct the hormonal background of a woman so that the implanted embryo does not reject, and the body accepts the implant.

Preparing a woman

Practice has shown that insufficient preparation of the body for in vitro fertilization can adversely affect the result. Therefore, each patient should take the recommendations of specialists responsibly and conscientiously follow the instructions. Preparation for fertilization consists not only in passing the necessary tests, but also in observing certain rules for a woman:

• do not take medicines without the consent of the doctor;
• - high protein content and the rejection of low-quality, fried and canned foods;
• observe an active drinking regime - from two liters per day;
• do physical exercises to activate blood circulation.

Also, the expectant mother must undergo routine vaccinations that will protect her and the unborn baby from serious diseases. The list of mandatory vaccinations includes a rubella shot if there is no immunity to it: rubella disease is a good reason for terminating a pregnancy.

The lifestyle before the procedure must be changed: alcohol and tobacco are strictly prohibited for both spouses, a coffee drink is allowed in the amount of one cup per day. Be careful with temperature changes, for example, do not go to the steam room. Sleep should last about eight hours a day, as sleep deprivation negatively affects overall well-being and health.

Weight control is important. During IVF or ICSI procedures, weight loss diets should not be used, as this disrupts the hormonal background. All manipulations with weight must be completed in advance. The diet during the preparatory period should be balanced. It is recommended to give preference to protein products, cereals and fast carbohydrates.

Before fertilization, it is necessary to get rid of gynecological diseases, to prevent the exacerbation of chronic ailments of other organs and systems. It is important to understand that taking medications during the preparation and conduct of artificial insemination is unacceptable - this can cause rejection of the implanted embryo.

morale

Many patients are interested in: IVF or ICSI - which is more likely? The choice of procedure will be made by the embryologist based on the study of the analyzes. However, the guarantee of implantation success also depends on the patient herself. Doctors have long known caused by subconscious fear or disbelief.

If a woman has complexes regarding conception or a subconscious fear of pregnancy, it is necessary to undergo a course of psychotherapeutic procedures. A conversation with psychologists and psychotherapists will help get rid of internal blocks and conceive a child.

A big psychological problem is obsession with conception and pregnancy, when a woman puts this task above all else. A passionate desire to become a mother can postpone the desired moment for several years. Pregnancy should be perceived as a natural process available to all women. If there are no medical contraindications to conception, it should inevitably happen: you should not worry too much about this.

Preparing a man

Fertilization of the egg is possible only with the participation of healthy active spermatozoa, which are carriers of the father's genetic material. Therefore, the preparation of a man is no less important.

Before medical manipulations, the future father must undergo a special examination:

• to identify previously transferred diseases and surgical interventions;
• for the study of analyzes in the laboratory;
• determination of sperm quality - spermogram.

It is very important and allows you to find out:

• the number and activity of spermatozoa;
• viscosity, color and volume of semen;
• the presence of pathogenic microorganisms;
• acid-base level.

If the analysis reveals deviations from the norm, the man is prescribed a course of therapy. After treatment, the sperm is again taken for research.

In some cases, a blood test for hormones is required. This is due to the presence of defects in the Y chromosome or the absence of the vas deferens. These pathologies may be hereditary. In exceptional cases, donor sperm can be used for conception.

IVF and ICSI HIV-infected

Is it possible to conceive an HIV-infected patient? For this category of persons, a more thorough preliminary preparation, determined by a specialist, is assigned. You should also be aware that in this case:

• IVF or ICSI is not performed in the subclinical phase of the disease;
• conduct a course of antiretroviral intensive therapy to prevent infection of the fetus;
• An HIV-positive father undergoes a seminal fluid cleansing procedure to protect the embryo from infection;
• the sperm of an HIV-positive father undergoes a control test before fertilization of the egg.

IVF or ICSI - which is better for HIV-infected patients? In this case, the method will be chosen by the embryologist based on the tests. For successful completion of the procedure, it is necessary to know in advance about the necessary analyzes and the timing of their implementation.

1. You need to know about the expiration dates of the tests so as not to retake them again.
2. You should find out which tests are taken on an empty stomach, and which ones are taken on a certain day of the menstrual cycle.
3. It is better to make a preliminary appointment for blood sampling, urine and other procedures.
4. Before signing an IVF contract, you should carefully study all the points.

Remember that a positive result depends not only on specialists, but also on the patients themselves - their attentive attitude to their own health.

The difference in terms of efficiency

Many women are convinced that it is the difference between IVF and ICSI that plays an important role in successful fertilization. In the event of an unsuccessful IVF procedure, some patients think that ICSI should have been done. However, this is misleading.

Should we give up and accept our fate? The success of the procedure largely depends on the psychological mood of the patient and her preparation for conception. In case of non-compliance with nutritional standards, lack of physical activity and an unhealthy lifestyle, no one can guarantee a successful pregnancy.

Outcome

Is there an alternative to artificial insemination? In many countries, surrogate motherhood is practiced - this is a chance to have a healthy child of your own. It should be understood that for successful IVF or ICSI it is necessary to have a healthy reproductive system, and if artificial conception is not possible, alternative methods should be used.

The purpose of every woman is to be a mother. But not everyone can get pregnant easily. In this case, modern methods of reproduction come to the rescue - IVF and ICSI. Both methods of infertility treatment are similar to each other. Fertilization of the egg does not take place in the woman's uterus. Before the procedure itself, there is a protocol that includes stimulation, sampling, insemination and selection of embryos.

ICSI or IVF

The main difference between IVF and isca is the processing of spermatozoa. The choice of one or another method depends on the degree of infertility, the indications for the procedure, the cost of the procedure, and the results of the diagnosis of a man and a woman.

Only after that the reproductologist makes a decision. What is more effective than IVF or ICSI can not be unambiguously answered by any specialist. the procedure is supported individually.

What is the difference between ICSI and IVF

• fertilization method.

Eco in this case resembles the usual process of conceiving a child. Sperm and egg are placed in a test tube in random order. But at the same time, spermatozoa in the ejaculant must be mobile and strong. IVF is suitable for advanced forms of infertility. During IVF fertilization, tens or even hundreds of spermatozoa are needed.

During ICSI fertilization, the best spermatozoon is selected. The process itself does not take place in a test tube.

The reproductologist observes the course through a microscope, using various devices (suction cups, needles). With the help of a needle, the sperm is injected into the egg.

In simple words, two droplets (sperm and egg) are combined, after successful fertilization, the finished embryo is placed in the uterine cavity. Specialists monitor the hormonal background of a woman.

• medical indications.

When choosing the ixi method, the reproductive specialist is based on the overall clinical picture. A man needs to pass a spermogram. If, according to the results of the examination, there is a small number of healthy sperm, insufficient volume, asthenozoospermia, and more, then ixi is prescribed. Perhaps the specialist will prescribe treatment for the partner to improve the quality of sperm. Drug treatment is used, smoking and alcohol cessation is recommended, a set of physical exercises is prescribed, a nutritionist selects a balanced diet. A second semen analysis is done. Ixi is also prescribed after unsuccessful IVF, low egg counts, for women aged 38 years and older.

Indications for IVF

IVF is indicated for women who have not been able to conceive for more than 3 years. At the same time, no violations were revealed in the sexual partner after the diagnosis of the spermogram. Spermatozoa are active and healthy, there is a sufficient number of them. Also, a woman has diseases of the uterine tubes, disorders in the endocrine system, hormonal disruptions in the body, endometriosis.

There is no difference between IVF and ICSI for a woman in terms of sensations from the procedure. Differences in protocols can be observed, but they are directly applied only to the partner.

If we compare the statistical data, then the effectiveness of ICSI in the case of high-quality sperm and eggs ranges from 20-70%, IVF - 30-40%.

Again, the percentage may decrease if the specialist uses frozen cells. A positive success gives the use of a surrogate mother, if there are developmental problems and diseases of the uterus.

If we talk about the cost of these procedures, we cannot say that the method of fertilization is cheap. In figures, this amount can range from 45-100 thousand rubles.

And not always a positive result is possible on the first try.

Using the state quota, you will not have to pay for the fertilization process. But in this case, the choice of method is left to the reproductive specialist.

Video: IVF or ICSI

Conclusion

I would like to note that the experience gained over the years in this area does not affect the future health of children. Babies conceived naturally, or through IVF, are absolutely no different from each other, if anyone else has doubts.

What is the difference between IVF plus ICSI and IVF and is there a difference?

What is the difference between ICSI and IVF? There are two main differences between these - this is the method of selection of spermatozoa and the degree of intervention in the process.

• Sperm collection during ICSI
• The main difference. fertilization process
• The difference in indications
• What is the difference for patients?
• findings

Selection of spermatozoa in in vitro fertilization

The difference in indications

In the list of indications for ICSI, there is also a difference from IVF. Mostly, micromanipulation is resorted to when - unsatisfactory sperm counts or the use of frozen eggs (after thawing, their cell wall becomes denser). For IVF, the majority of indications are from women: infertility of unknown etiology, age patients.

Most often, the IVF protocol is the first step in overcoming infertility. ICSI is an alternative for failures in the past or with.

How is physiological ICSI different?

Unlike IVF, ICSI is a financially more expensive procedure, its cost depends on the number of full-fledged eggs received.

findings

ICSI is a possible component of the IVF protocol, which is performed according to indications. When using micromanipulation, in vitro fertilization becomes more costly.

Actual video

You can watch a video in which you can clearly see the difference between IVF and ICSI fertilization processes.