Do IVF or ICSI Embryos Grow Better?

IVF vs ICSI is a hotly debated issue, and while ICSI is often suggested for patients, they actually may not need it. It's important to note that the shift towards ICSI is so great that in some countries, more than 95% of cycles are completed this way.

For some patients, the option to have IVF insemination may not be possible. However many patients that present with normal semen samples and have only tubal infertility or even simply irregular periods are told that ICSI will lead to more successful outcomes.

There have been some studies that demonstrate patients who present with Advanced Maternal Age, low ovarian reserve, and unexplained infertility do very well using IVF insemination.

The mindset of primarily using ICSI is largely based around fertilization rates. On a whole, ICSI leads to higher fertilization rates than conventional IVF. That said, IVF can also lead to strong results when done properly.  Many labs with below average IVF fertilization rates don’t invest in improving their processes because ICSI is available.

ICSI is a great option for patients with male factor infertility. However, there is also likely a natural selection criteria for sperm that successfully enter the egg that we cannot replicate with ICSI. 

There is the option to split the cycle so that some eggs are fertilized with ICSI and some through conventional IVF.

The above embryos were from a split case. We fertilized 7 eggs with ICSI, 5 fertilized, and 5 grew to blastocysts. The eggs used in conventional IVF saw 4 inseminated, 3 mature, 3 fertilize, and 2 develop to blastocysts. We transferred the IVF embryo (bottom right) because it was the highest grade, even though 2.5x more embryos were available through ICSI. This patient wanted some embryos from conventional IVF just to broaden her options and was surprised when we let her know that we recommended transferring 1 of her 2 blastocysts from conventional IVF.

We are very happy with our IVF rates and see fantastic embryos at the blastocyst stage. We now also use IVF in PGS cycles and get good results. We recommend discussing IVF vs ICSI with your doctor to learn more about your options.