Which method is more successful — in vitro (IVF) or ICSI (ICSI)?
When we talk about assisted reproduction, the most commonly mentioned terms are in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).
And many patients ask: “And which of the two methods is better?”
The truth is: it is not about competition, but about making the right choice according to the case.
What is IVF?
In the classic in vitro procedure, the eggs and sperm are placed in a common petri dish with a special medium and fertilization occurs “naturally” - the strongest sperm penetrates the egg itself. In this procedure, normal or close to normal spermogram parameters are required.
What is ICSI?
In the ICSI procedure, the embryologist selects one morphologically normal sperm under a microscope and injects it directly into the cytoplasm of a mature egg. This procedure is suitable for male sterility factor, azoospermia, low sperm motility, previously unsuccessful fertilization with an IVF procedure.
Success — is there a difference?
At the level of “will the egg be fertilized”? YES.
- ICSI has a higher fertilization rate (up to 70— 80%), especially with the male factor;
- In IVF — fertilization varies between 40— 70%, depending on the quality of the sperm.
At the level of “pregnancy and childbirth”? NOT ALWAYS.
- If the spermatozoa have good indicators, the difference between IVF and ICSI in the final result is minimal;
- ICSI does not guarantee a higher degree of pregnancy if there is no medical need for it.
When is ICSI preferred?
- Male sterility (oligozoospermia, asthenozoospermia, teratozoospermia);
- Azoospermia and the use of sperm from testicular biopsy;
- Previous failures in fertilization with IVF;
- Frozen eggs;
- PGT (preimplantation genetic diagnosis);
- Limited number of eggs — control is important.
When can classical IVF be applied?
- Normal or borderline normal sperm indicators;
- Preference for a more physiological process;
- Higher egg count and low risk of lack of fertilization.
Conclusion
ICSI is no better. IVF is not weaker.
Both are powerful tools when used on the spot.
Success does not depend only on the method, but on whether it is chosen correctly according to the couple.
Therefore, the decision is made not “by catalog”, but after an individual assessment by the team.