ICSI & IVF Treatment Options
Within IVF, there are two different insemination techniques: standard insemination and ICSI insemination. Standard insemination is a procedure in which the eggs retrieved are maintained within their cumulus complex and are combined with sperm in the same culture dish. Because their cumulus complex is maintained, egg quality and maturity cannot be evaluated.
In order to perform ICSI insemination, the cumulus complex of the egg is removed and the egg maturity and quality are evaluated. Maturity of the oocyte is important because only mature eggs have the opportunity to fertilize. ICSI involves the insertion of a single sperm directly into the cytoplasm of a mature egg. ICSI is typically recommended if a patient has one or more of the following:
RISKS
What are the risks with In-Vitro Fertilization (IVF)?
The medications and procedures required for In-Vitro Fertilization (IVF) are rarely associated with complications. However, as with all medical treatments, there are potential problems that may occur.
Ovarian hyperstimulation syndrome can occur whenever women use ovarian stimulation medications, especially injectable gonadotropins, such as Gonal-F, Bravelle, Follistim, or Menopur. This complication occurs in less than one percent of women who have egg retrieval with IVF. When severe, ovarian hyperstimulation can lead to dehydration, large amounts of fluid accumulation in the abdominal and lung cavities, and blood- clotting disorders. IVF cycles may be cancelled or embryo transfers postponed in order to prevent ovarian hyperstimulation syndrome.
Controversial studies link ovarian stimulation drugs to the development of ovarian cancer. Although studies are contradictory, some researchers have reported an increase in borderline ovarian cancer in women who have used fertility drugs. Until further research is available, careful use of ovarian stimulation drugs is reasonable, but it also is important to note that pregnancy reduces the lifetime risk of developing ovarian cancer.
What are the risks with IVF and a healthy pregnancy?
There is not an increased risk of birth defects in children conceived through IVF. The rate of pregnancy loss or miscarriage (about 20 percent) is similar to that of the general population and is related to the age of the female partner. The risk of ectopic (tubal) pregnancy is about 2 percent.
The risk of multiple gestation—twins, triplets, and higher order multiple pregnancies— is more common in women who undergo IVF. The rate of having twins with IVF is approximately 25 percent and the rate of having three or more babies is approximately 5 percent. Multiple pregnancies are complicated by an increased risk of premature labor, premature delivery, maternal hemorrhage, cesarean delivery, pregnancy-induced high blood pressure, and gestational diabetes.