IVF/ICSI
What is Assisted Reproductive Technique (ART)?
The procedures which involve the handling of the male and female gametes (egg and sperm) outside the human body constitutes ART.
IVF is a process where a sperm fertilizes an egg outside the human body in a petridish. ICSI is a process where a sperm is injected into the cytoplasm of an egg, under microscopic guidance.
What are the indications of IVF/ICSI?
Your doctor may advise you to undergo this procedure if:
- Fallopian tubes are blocked
- Multiple cycles of failed ovulation Induction/IUI
- Poor ovarian reserve
- Severe oligoasthenoteratospermia or azoospermia(very low sperm count)
- IF preimplantation genetic testing of the embryo is indicated
- Unexplained Infertility
- Severe Endometriosis
How is the IVF/ICSI procedure carried out?
The procedure starts on day 2/ day 3 of the menstrual cycle. Vaginal scan will be done and daily injections started. The injections last for a period of 9-13 days on an average. 3-4 follicular scans will be done during this time. Mature eggs will be aspirated from the follicles, under anesthesia by a process called Ovum Pick Up(OPU).
The eggs are fertilized be sperm in the lab. The embryos are cultured upto day 3,4 or 5 and transferred back to the uterus. Pregnancy is normally tested about 2 weeks after the embryo transfer.
What is the success rate of IVF/ICSI?
The chance of a healthy pregnancy with one cycle of embryo transfer is 60-65%. If excess embryos are available after transfer, they are frozen in liquid nitrogen. These can be used anytime during the next 5 years. Thus the cumulative pregnancy rate increases for each embryo transfer cycle.
What are the complications associated with IVF/ICSI?
Complications are mostly related to the medications used. About 20-25% experience mild symptoms such as abdominal bloating, nausea, headache, tiredness. Ovarian hyperstimulation syndrome seen in women with PCOS and increased AMH values is preventable with the judicious use of medications for ovarian stimulation and doing frozen embryo transfer where indicated.
Multiple pregnancy (twins/triplets) is directly related to the number of embryos transferred and the number which implant. Hence, it can be avoided by transferring only the required number of embryos.
Will the child conceived through IVF/ICSI be different than that conceived without?
This process involves the fertilization of egg by the sperm when it fails to happen naturally. Nothing much is done which affects the genetics of the embryo. The risk of major congenital malformation in a natural conception is 2-3%, which is the same for a child conceived through ART.
What else should I know?
Some common myths cleared:
- IVF/ICSI procedure can be planned and the visits scheduled as per your daily routine.
- The pain associated with it is mostly of the injections used.
- No increased risk of cancer/ weight gain after the procedure.
- Complete bed rest is not indicated in all women undergoing IVF/ICSI.
- You can have a normal pregnancy and normal delivery after IVF/ICSI.
- It is possible to have a natural pregnancy after undergoing the procedure(to further expand your family, if required)
Which doctor is best for IVF?
Dr Sneha J is a Gynecologist and best fertility specialist. She has completed MD OBG from the top university AIIMS , Delhi and University fellowship in Fertility/ Reproductive medicine. She had further training in dealing with these conditions, as a visiting fellow at high output centres in Madrid, Spain and Chicago,USA. A gynaecologist experienced in treatment of these conditions is best for IVF treatment.
Frequently Asked Questions
Both are assisted reproductive techniques, but fertilization happens differently. In IVF, sperm and egg are combined in the laboratory, while ICSI involves injecting a single sperm directly into the egg under microscopic guidance. The choice between IVF vs ICSI depends on factors such as sperm quality, previous fertilization results, and the couple's fertility history.
The treatment generally begins around day 2 or day 3 of the menstrual cycle. According to the page, daily stimulation injections usually continue for around 9–13 days, followed by egg retrieval, laboratory fertilization, embryo culture, and transfer. The overall IVF treatment timeline can therefore vary depending on embryo development and the treatment plan.
Some discomfort can occur with fertility injections, and the page identifies injection-related discomfort as one of the more common concerns. The amount of discomfort can vary between individuals, so patients can discuss IVF injection pain and practical ways to manage it with their fertility team.
If suitable embryos remain after the planned embryo transfer, they can be cryopreserved in liquid nitrogen for potential future use. The page states that these frozen embryos can be used during subsequent transfer cycles, making frozen embryo transfer an option for some patients.
The page states that excess embryos are frozen in liquid nitrogen and can be used anytime during the next five years. The suitability and timing of a future transfer will depend on the patient's circumstances and treatment plan, so embryo freezing can provide additional opportunities without repeating the entire egg-retrieval process.
No. The page specifically states that complete bed rest is not indicated for all women undergoing IVF/ICSI. Patients should nevertheless follow their fertility specialist's individual instructions regarding activity, medications, and follow-up after embryo transfer.
Yes. The page states that women can have a normal pregnancy and normal delivery after IVF/ICSI. Pregnancy care is still individualized, and the treating obstetric team will monitor the pregnancy according to the mother's and baby's circumstances after IVF pregnancy is established.
The page states that IVF/ICSI treatment can be planned and clinic visits scheduled around a patient's daily routine. However, appointments and monitoring scans are necessary during ovarian stimulation, so IVF cycle planning should be coordinated with the fertility clinic in advance.
Yes. Under some circumstances, a couple may conceive naturally after completing an IVF/ICSI treatment cycle. The page specifically notes that natural pregnancy can occur later if the couple wishes to expand their family, although future fertility depends on individual reproductive factors and circumstances. Natural pregnancy after IVF is therefore possible for some couples.
Follicular scans allow the fertility team to monitor how the ovaries are responding to stimulation and how the follicles are developing before egg retrieval. The page states that around three to four scans are generally performed during the stimulation period, making follicular monitoring in IVF an important part of treatment planning.
