Conventional In Vitro Fertilization and Intracytoplasmic Sperm Injection

In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are assisted reproductive technologies used to help individuals or couples conceive a child. IVF involves combining an oocyte and sperm outside the body in a laboratory to create embryos. Following ovarian stimulation, oocytes retrieved through a minor surgical procedure are mixed with sperm in the laboratory. If fertilization occurs, resulting embryos are cultured for several days, and one (or more) embryo(s) is (are) then transferred into the uterus (either "fresh" or after cryopreservation) in hopes of implantation and pregnancy. Conversely, ICSI is a specialized form of IVF typically used when male infertility is a concern, or in previously failed conventional insemination, whereby a single sperm is injected directly into an oocyte using a fine needle. This bypasses issues like low sperm count, poor sperm motility, or abnormal sperm shape, as well as some other potential gamete structural or physiological impairments. ICSI follows the same general steps as IVF, but it requires the use of a microscope and micro-manipulators, which makes the fertilization process more predetermined. The success rates of IVF and ICSI depend on factors such as age, fertility issues, and overall health. Importantly, it has been demonstrated that IVF and ICSI are likely not increasing risks of genetic/chromosomal abnormalities in fetuses nor are they associated with increased risks of malformation of children born. IVF/ICSI can use a partner's or a donor's oocytes and sperm. Both IVF and ICSI, outlined in this chapter, are continually advancing, improving success rates and safety.