What Is the Difference Between IVF, ICSI, IUI, and PICSI?

When you first venture into the world of fertility treatment, it doesn’t take long to hit the slightly infamous wall of acronyms, formed of IVF, IUI, ICSI, and PICSI. While each of these treatments share the same goal of helping you raise a child, their paths to reaching that goal differ in more than a few ways. If you’ve hit this wall already and are wondering what these treatments involve, you’ve come to the right place. Let us explore the key differences among these procedures and help you choose the best one for your situation.

What are assisted reproductive treatments (ARTs)?

We are all well aware of how complicated a pregnancy can be. Even at the very start of this process, there are a lot of things that need to be near-perfect for fertilisation to happen – egg quality, sperm quality, hormones, timing – you name it. When even a single one of these factors falls out of place, getting pregnant can easily go from complicated to borderline-impossible. Thankfully, this is where assisted reproductive treatments (ARTs) come in to save the day.

These are medical procedures that are purposely designed to help people conceive when it isn’t happening naturally. All the acronyms being discussed today fall under this umbrella term, and, as mentioned at the start, each works a little differently to achieve the same goal.

But why establish the concept of ARTs before proceeding further? It’s to help you understand that there is no one option of getting pregnant that is universally considered the best. The right ART for you will depend on things like your diagnosis, age, fertility history, and the results from your fertility tests. What works for one person may be completely useless for another, even if the situations feel familiar on the surface. But now that all the essential groundwork is complete, let us walk through each treatment and identify the differences between them.

What is IUI?

IUI, or intrauterine insemination, is the least invasive fertility treatment of the bunch and is often the first one your doctors will ask you to undergo. In it, a bit of prepared sperm from your partner or done is placed directly into your uterus when you’re ovulating, bypassing the cervix. This is done to give the sperm a better chance of reaching the egg and let the fertilisation still happen naturally. Generally, this treatment is done either during your natural cycle or with hormonal injections that can trigger ovulation.

Outside of being a starting point for fertility treatments, this procedure is also suggested for couples dealing with male infertility, problems with cervical mucus, unexplained difficulty in getting pregnant, or when using donor sperm.

That said, there are a few things you need to know about IUI. Since the fertilisation still happens inside the body, the level of control doctors have over the process ends when the sperm is placed in the uterus. Not only that, but because its success rates are lower than those of IVF, it is usually considered only a first step in this journey rather than its end.

What is IVF?

IVF, or in vitro fertilisation, is the most popular assisted reproductive treatment out there – one in which fertilisation occurs outside your body and in a lab. To begin this procedure, you first need to take a few hormonal injections to help the ovaries produce several eggs at once. Once you do so, the doctors will collect all the eggs and try to fertilise them with prepared sperm from your partner or donor. If an embryo forms successfully, it is then placed back into your uterus in hopes of a successful pregnancy.

Since doctors have way more control here and monitor nearly every step of the process, IVF proves to be not only more precise than IUI, but also the treatment with higher success rates. Plus, IVF can practically be a life-saver for situations involving blocked fallopian tubes, severe endometriosis, prolonged unexplained fertility, or if the IUI couldn’t help in your situation. Considering how it is also used for fertility preservation, genetic testing, or when donor eggs are needed, it becomes quite clear that IVF is something of an all-rounder treatment that can tackle a lot of fertility issues at once.

What is ICSI?

ICSI stands for intracytoplasmic sperm injection, and contrary to all the misconceptions out there, it is not a separate treatment from IVF. It is a key fertilisation technique used during an IVF cycle to further improve a couple’s chances. Here’s what happens: in a standard IVF, the eggs and sperm are placed together in a lab environment so that fertilisation can happen on its own. But when ICSI is added into the mix, a single sperm is directly injected into the healthiest egg of the bunch using special, microscopic tools. By doing so, the doctors try to remove the element of chance from the embryo formation process at the very least.

That’s really all there is to it, and the rest of the IVF process stays the same. Interestingly, doctors tend to save ICSI for cases related to male infertility. If it’s low sperm count, poor motility, abnormalities in the sperm cells, or if a previous IVF cycle was not successful, then ICSI is undertaken to save the day.

What is PICSI?

PICSI, or physiological intracytoplasmic sperm injection, is a more specialised form of ICSI – you may even think of it as a refinement of sorts. The main difference between it and the previous technique lies in how sperm cells are selected at the start.

In PICSI, sperm are tested to see if they can attach to hyaluronan, a natural substance found around the egg – the test is done using hyaluronic acid in a lab environment. Doctors add this extra step because these sperm are usually more mature and have better DNA, which as many studies have shown, improves the chances of a healthy pregnancy.

But given its specialised nature, this technique is only suited to the most specific of situations. Doctors may recommend going for it if there are either too many sperm cells with damaged DNA, if the female partner is over the age of 38 and wants to ensure a healthy pregnancy, if the regular ICSI failed to provide results, or if the embryo quality from ICSI was simply not up to par.

How do doctors decide which treatment is right for you?

So here’s the hard truth of all fertility treatments: you cannot make a choice between them based on your preferences or through advice from others. It is something that only your fertility specialist can decide based on your and your partner’s test results, medical history, age, and how you have responded to similar treatments in the past. If you want to know more, it is best to get in touch with a fertility clinic in London, UK, to receive the right guidance and a personalised plan that is tailor-made for you.

But regardless of whether you get to choose or not, it is still important to know what these treatments are like. Don’t forget that simply knowing when and why you’re going through a particular procedure can help lower your stress and anxiety by quite a bit.

It is an undeniable fact that fertility treatments can be stressful and overwhelming, especially if you find yourself feeling unsure and uncertain about the future. When you understand what is being suggested and how it fits your situation, the storm that hangs over your fertility journey can start to ease up. Each of these treatments is designed to help you raise your family, so just take the first step, trust the process, and keep moving forward without giving up.