IUI, IVF, ICSI – what do they all mean?
These are all different methods available to try and help couples conceive. Their names might seem a bit confusing at first, but hopefully this post will try and clear things up a bit!
IUI- Intrauterine Insemination
Also known as artificial insemination, this method can be used in couples affected by ovulation problems or mild endometriosis, as well as problems with the cervix or when there is a male infertility problem such as impotence of premature ejaculation . IUI is not used in couples with ovarian failure, or problems with the fallopian tubes, such as damage or a blockage.
The idea of IUI is that the better sperm (faster moving) are removed from a semen sample and then only these are placed inside the uterus around the time of ovulation in the woman (36-40 hours after), giving the best chance for fertilisation of the egg. The time of ovulation is the time in the monthly cycle when the egg is released from the ovary (around day 15 of the cycle). IUI can be used with or without the use of fertility drugs that increase the number of eggs released during ovulation.
A special instrument called a speculum is inserted into the vagina to make space for a small catheter that is inserted into the uterus. The specially selected sperm are inserted through the catheter in the hope that one will fertilise the newly ovulated egg. It is a quick and painless procedure that causes little risk to the woman. This procedure can be carried out multiple times on different cycles if the previous unsuccessful.
IVF- In vitro fertilisation
As discussed in the last post, IVF is when the egg and sperm gamete cells are collected from the parents and allowed to fertilise outside of the body in a dish in a laboratory. The sperm can be left to naturally fertilise the egg, or can be directly inserted into the egg cell. This is known as Intra-cytoplasmic sperm injection (ICSI).
ICSI- Intra-cytoplasmic sperm injection
Directly injecting a sperm cell into an egg cell means that even men with a low/zero sperm count, or those that have poor sperm motility can father a child. ICSI can be carried out if previous tries with IVF have been unsuccessful, or the embryos are not fertilised without help.
A semen sample is collected from the man, and the best quality sperm cells are used to fertilise eggs from the woman, outside of the body by embryologists. Sperm can be collected from a fresh sample or in men unable to do this due to errection problems due to spinal injuries or other disorders a sample can be collected direct from the epididymis using a syringe (where the sperm are located whilst they mature). Extra sperm collected may be frozen for use later on in future cycles.
The best sperm are used to fertilise an egg, which is then transferred into the woman’s uterus 2-3 days after growing in a lab, exactly the same as in IVF, or after 6 days as a blastocyst transfer. It is then a waiting game, waiting for the date in which a pregnancy test can be taken to given a result of a positive pregnancy of a failed cycle of IVF…a day that can cause either great joy or disappointment to couples that have gone through these procedures.
Below is a really good youtube clip detailing the ICSI process, as well as other processes such as the collection of eggs during IVF and ICSI.
Counselling is always offered to couples undergoing these assisted reproductive methods as it can often be physically and emotionally draining . Counselling is offered before, during and after IVF treatment (successful or not) to help manage the whole process and dealing with any issues in regards to the couple’s fertility.
 What is IUI and how does it work, Hfea, available at: http://www.hfea.gov.uk/IUI.html
 IVF support, available at: http://www.nhs.uk/Conditions/IVF/Pages/Recovery.aspx