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IVF And ICSI Basics: What’s The Difference Between IVF And ICSI?

Here we aim to explain the basics of IVF and ICSI treatments (In Vitro Fertilisation (IVF) and Intracytoplasmic Sperm Injection (ICSI)), establishing the main differences between each.

What Is IVF?

IVF (In Vitro Fertilisation) is one of the most commonly used fertility treatments. . The process involves retrieving the woman’s eggs and placing them into a laboratory dish that contains prepared sperm, that has been provided by the male party. When placed together in the dish, the sperm will penetrate and attempt to fertilise the eggs naturally, creating embryos.  These embryos are then monitored by an embryologist for up to 5 days and then when the time is right, the strongest are selected and transferred back to the womb at the right time, or frozen for later use.

Who Is IVF For?

IVF was originally designed to assist with fertility issues due to blocked or damaged fallopian tubes. However, due to its success, it now treats a broader range of infertility problems. This includes:

IVF Risks

Before proceeding with any form of fertility treatment, it is important to understand the risks involved. Potential IVF risks include:

Poor Response: When going through IVF,  tests are conducted to predict ovarian response. However, sometimes, an inadequate response might occur. This essentially means that the ovaries fail to respond to stimulation, making it difficult to collect any eggs.

No Eggs: Although rare to happen unexpectedly, you may find that no eggs can be collected when attempting IVF. This links to poor egg quality, which might suggest that another form of fertility treatment (such as an egg donor) is needed.

Ectopic Pregnancy: Unfortunately, up to 5% of  IVF and ICSI pregnancies may be ectopic. This means that the pregnancy occurs outside of the womb, affecting miscarriage rates by around 10%.

Ovarian Hyperstimulation Syndrome: As the name suggests, OHSS occurs when the ovaries get overstimulated. Although a rare risk of IVF, it’s important to be aware of, as a small number of OHSS cases require hospitalisation.

Just as with any form of treatment, always speak to your fertility consultant about the risks involved with IVF or ICSI.

What Is ICSI?

ICSI stands for Intracytoplasmic Sperm Injection. It is a type of IVF that similarly involves the retrieval of eggs and then selecting a single sperm and injecting it directly into an egg. The fertilised egg is then transferred into the womb at the right time, in the same way as it is with IVF.

Who Is ICSI For?

ICSI is often recommended for those affected by male infertility (sperm-related infertility). Sperm-related infertility includes, but is not limited to, low sperm count,  poor sperm motility or abnormal sperm shape.

ICSI might also be recommended to those with the following problems:

ICSI Risks

ICSI was introduced in 1992, making it a slightly more modern type of fertility treatment than IVF. Whilst many babies have been born using ICSI, it is not yet known if there are any long-term risks involved for children conceived by ICSI. Current known risks are the same as the IVF risks mentioned earlier in this guide.

The Main Difference Between IVF and ICSI

The main difference between IVF and ICSI involves the contact made between the sperm and the egg. With ICSI, each egg is injected with a single sperm. With IVF, the sperm naturally penetrates the egg.

How Are IVF and ICSI Similar?

ICSI is a form of IVF, meaning that the two treatments have a lot of similarities. Once both treatments have witnessed the sperm fertilise the eggs, the process remains the same for both types of treatment. The embryos are monitored in an incubator for up to five days, at which point the strongest embryos are replaced back into the womb.

What’s Best For You?

IVF is one of the most common and effective forms of fertility treatment, with over eight million babies born through IVF and counting! However, this treatment isn’t suitable for everyone, and your fertility specialist may recommend an alternative treatment based on your specific circumstances.

Simply put, there’s no “one-size-fits-all” approach when it comes to fertility treatments. Each body works differently and therefore may require a different approach.

To Summarise

IVF and ICSI are both key types of fertility treatment that are responsible for thousands of pregnancies each year.  Although very similar treatments, ICSI involves injecting sperm into an egg, whereas this process happens naturally during IVF. For this reason, ICSI treatment is more tailored to those with issues relating to male infertility.

When it comes to deciding what form of fertility treatment is best for you, your fertility specialist should always guide you.. Here at Fertility Plus, we can talk you through your options and help to find the most suitable treatment for your situation.  You can contact us to book a consultation.

9 Important Questions To Ask Your Fertility Consultant

For some patients, going to a fertility clinic can feel like a nerve-wracking experience.  One way to feel more relaxed about your appointment is to prepare a few essential questions in advance, so you can be sure that your consultant answers everything you need to know. Here are nine important questions to ask your fertility consultant. 

1. What Is My Diagnosis And How Does It Interfere With Fertility?

The first question to ask is what your specific diagnosis is and how it affects fertility. There are many causes for infertility, so your consultant should explain to you what the issues are and how they directly correlate to your infertility. Following on from this, they need to explain whether those conditions may change over time, will they get worse, stay the same or if there’s potential for them to improve. 

2. What’s Your Clinic’s Success Rate Overall, And For Patient’s With My Condition?

It’s worth checking in with your consultant as to how successful they’ve been with treatments for patients in the past. Finding an IVF clinic in London that has had success with IVF cycles and live births for their patients, as well as a clinic that has worked with patients with similar backgrounds to you and your partner can help increase your chances of success. 

3. Are Less-Invasive Treatments Available?

Once your consultant has explained the potential treatments available to you, you should ask if there are more conservative treatments available and how these compare to the treatments they recommend in terms of success rates and the associated risks. Every treatment, whether it’s assisted conception, surgery or medication, comes with its own pros and cons and side effects, so you should weigh up what those are and discuss the options with your doctor. 

4. What’s The Estimated Timeline For My Circumstances?

The process of your treatment and the timeline may differ from the projections your consultant gives you. For most people, a single cycle of IVF can take between four and six weeks, but it depends on the individual’s circumstances – some women, for example, may not have the first stage of treatment which suppresses hormone production, which can reduce the time by several weeks. 

5. How Many Embryos Are Typically Retrieved And Transferred To A Patient Like Me?

The number of embryos retrieved will depend on your health and your age, so this is a valuable question to ask your consultant as they may suggest just taking a single embryo or several. The latter will increase your chances of getting pregnant, however a single embryo retrieval is safer for the mother and baby. It can also be worth asking whether they prefer fresh or frozen embryos. ‘Fresh’ embryos, or non-frozen embryos, are transferred shortly after the eggs are fertilised while freezing can take a few extra weeks but might increase the chances of conceiving for some patients. 

6. How Many Cycles Of Treatment Are Recommended Before Trying Other Options?

This will vary between clinics and specialists, so it’s a valuable question to ask. Some consultants recommend skipping a menstrual cycle between each treatment cycle, and there may be a set number of tries they suggest before switching to another treatment. It will help you set out expectations early on and will help you plan ahead if you’re not seeing the right results from your sessions. 

7. Do You Recommend Any Additional Lifestyle Modifications?

While your treatment will be the main focus of your fertility journey, there are ways that you can support the treatment by modifying your lifestyle. Your consultant is the expert in terms of the specific treatment you’re receiving so they’re the best source of advice in terms of the changes you can make to increase your chances of getting pregnant. They may suggest increasing the amount of exercise you do each week, or cutting back on alcohol or giving up smoking, for example. They will have access to your medical history, and you can discuss your current lifestyle choices with them so they can provide additional guidance to aid your treatment. 

8. How Often Will I Be Communicated With For Updates?

The wait for updates is difficult – you want to know whether the treatment has been successful or if there are any problems, so knowing how often the clinic will be in touch can provide peace of mind. Most clinics have standard protocols for contacting patients with updates, whether that’s daily after retrieval or only getting in touch when they have news to update the patient with. You should also check who your point of contact will be if you have any follow-up questions or need further information after your appointment, so you’re not wasting time being moved between different members of staff. 

9. Will I See The Same Doctor Each Visit?

Patients place their trust in their fertility consultant and like to build a rapport with them so it’s important to know whether you will see your doctor every visit or if this can’t be guaranteed.  At Fertility Plus we do our best to have a one to one approach with our patients, meaning they see the same doctor each visit unless in exceptional circumstances.

Don’t Be Scared – Be Prepared!

Understanding which questions you want answers to before your appointment with your fertility consultant will ensure you maximise the time you have with them. It will also help you to feel better prepared and less overwhelmed by the prospect of speaking with your fertility consultant, as you’ll have the right information to the key questions before you start your treatment.

At Fertility Plus, we treat every patient as an individual, with a personalised treatment plan for each patient.  We believe this helps the patient feel comfortable throughout their journey and provides the best outcomes possible.

Treatments For Infertility: What Are The Main Types Of Fertility Treatment?

Infertility is a term used for people who have difficulty getting pregnant despite regular unprotected sex; it affects an estimated one in seven couples. While it’s a problem that affects many people, it can feel incredibly isolating and frustrating. There are many reasons why you or your partner may be experiencing difficulties conceiving and there are several treatments available depending on the cause of your difficulties. We’ve outlined the main types of fertility treatment to help you on your path to conception. 

Reasons For Infertility 

There are many reasons why you might be experiencing infertility and tests will be able to determine the most likely cause. Infertility problems can affect either partner, and common causes include irregular ovulation, low quality semen, blocked or damaged fallopian tubes, or endometriosis. 

There are other factors that can impact your fertility, including age, weight, stress, environmental factors such as exposure to certain pesticides or solvents, or excessive smoking or alcohol consumption. Certain STIs such as chlamydia can also affect fertility

The Main Types Of Fertility Treatment

The treatment you’ll receive will depend on the cause of the issue, and what your doctor recommends, but the three main types of treatment for fertility are:


There are several medicines available for fertility issues, including clomid tablets which contain clomiphene to encourage ovulation in women who don’t ovulate regularly or at all, and Tamoxifen which is an alternative to clomiphene for ovulatory issues.

Gonadotrophins can stimulate ovulation and can also be used to improve fertility in men with fertility difficulties, and Metformin may be prescribed for women suffering with Polycystic Ovary Syndrome (PCOS)

It’s important to speak to your consultant about the side effects of these medications, as they can vary from nausea and headaches to vomiting and hot flushes. Likewise, if you’re already taking medication, it’s essential that you confirm with your consultant that there are no contradictions with your fertility medication to avoid negative side effects. 


Surgical procedures are used to investigate infertility in more depth and to aid fertility. For example, fallopian tube surgery may be prescribed to repair broken or scarred fallopian tubes, helping to break up scar tissue so that the egg can travel through more easily.

For women with endometriosis, where parts of the womb lining grow outside of the womb, laparoscopic surgery can help to remove cysts and submucosal fibroids which may have developed in the womb. 

There are also surgical procedures for infertile men, such as correcting epididymal blockages which prevent sperm from being ejaculated. Surgical extraction of sperm can also be prescribed for men who either have an obstruction preventing a normal release of sperm, who have no vas deferens tube which drains sperm from the testicles, or who have had a vasectomy. 

As with any surgery, there are associated risks, such as the potential for complications.   It’s important that you and your partner weigh up the pros and cons of each option before deciding on the best surgery for your situation. 

Assisted Conception

IUI, which is also referred to as ‘artificial insemination’, is the process of inserting sperm into the womb surgically via a plastic tube through the cervix. The highest quality sperm are selected in order to increase the chances of successful implantation, and this process is often coupled with other treatments such as the FSH injection

IVF is one of the most common infertility treatments and it describes the process of fertilising an egg outside of the body and then implanting it into the womb where it grows and develops if it implants successfully.  ICSI is a form of IVF, however the key difference is the sperm is directly injected into the egg to create fertilization.

Finally, there’s egg or sperm donation that can be used to help couples conceive. Treatment using donor eggs or sperm is typically carried out using IVF. 

What Else Can Couples Do To Assist Fertility?

It can help to make lifestyle choices to assist your fertility treatments, to improve your health and wellbeing and put your body in the best health for pregnancy and parenthood. Excessive tobacco and alcohol consumption in men and women can be damaging to the body, including contributing to infertility, so it’s worth cutting back or avoiding completely to boost your health. 

If you’re on any prescription or non-prescription medication, discuss this with your GP as there are certain drugs which can affect your fertility – your GP may be able to prescribe an alternative in its place if the medication you’re taking may affect your fertility. However, don’t stop any medications suddenly without first discussing it with your doctor.

Final Thoughts

There’s a lot to consider when choosing infertility treatments, from the length of the treatment to the side effects and risks associated with each. Coming to terms with infertility can be emotionally draining, so it’s important to make the decisions as a couple, where relevant, and seek advice and guidance where possible to ensure you’re making the right choices for you and your relationship.

Smoking & Fertility: Does Smoking Affect Fertility?

The dangers that smoking can have on our health have long been known. What many people don’t realise, however, is the link it has to infertility. This article will take you through the dangers of smoking, including how it might affect fertility.

Does Smoking Affect Fertility?

According to the NHS, smoking can affect fertility. It has been found that smoking, including passive smoking, can “affect your chances of conceiving and also reduce semen quality”.

Unfortunately, it is not possible to know if you are experiencing any of the above problems which is why if you have been struggling to conceive it is important to seek professional help to get to understand if there is a fertility problem.  Fertility tests and assessments include fallopian tube testing, which looks to see if damage or blockage to the fallopian tubes is interfering with conception, Ovarian reserve testing which looks at the “female fertility potential” ie how long you have left to have a baby along with other tests as indicated.

In terms of semen quality, male fertility tests are also available; they help to see if poor sperm quality is interrupting conception.

I Don’t Smoke But My Partner Does – Will This Affect Fertility?

As mentioned previously, passive smoking (also known as secondhand smoke) is also harmful and might also affect fertility. 

Passive smoke is the smoke that you unintentionally inhale when around cigarettes – breathing in this secondhand smoke can be just as harmful as smoking a cigarette itself.

No matter their gender, if your partner is a smoker, they might be harming their and your chances of being able to conceive.

Will Quitting Smoking Improve My Chances Of Getting Pregnant?

There are many factors that can affect fertility, which is why there is no direct answer to this question. However, if you are looking to get pregnant or currently have trouble conceiving, quitting smoking is a great place to start.

Quitting smoking will be beneficial to your overall health. It usually takes around four weeks for withdrawal symptoms to alleviate, and within just one year of quitting, your risk of suffering from a heart attack halves.

Stopping as soon as possible will be a very sensible decision, but as a general rule of thumb, most people quit around four months before trying to get pregnant.

The Broader Dangers Of Smoking

There are over 50 health risks associated with smoking, meaning even if you aren’t trying to conceive, trying to stop should be a top priority.

According to the NHS, smoking is responsible for 7 out of every 10 cases of lung cancer. Not only this, but it can also cause cancer in other areas of the body, including the mouth and bowels.

Smoking can also damage your heart and blood circulation, increasing the risk of developing serious conditions like coronary heart disease. It also causes havoc with your respiratory system, linking to problems like asthma and recurring colds.

How To Stop Smoking For Good

It’s all well and good knowing how important it is to stop smoking, but we can’t ignore the fact that it is an addiction. Your body is addicted to the nicotine in cigarettes, making it extremely challenging to quit. With that in mind, however, it’s not impossible.

With the right help and guidance, you can quit this habit for good and get your health back on track.

Talk To Your GP

What’s important to remember is that you don’t have to go on this journey alone. Your doctor will be equipped with a lot of tactics to help you quit smoking, including prescribing medication or signing you up to support clinics.

Do It With Your Partner

If both you and your partner smoke, agreeing to quit together will help. Quitting together allows you to support and motivate each other, rather than lure each other back into temptation. Doing it together will also minimise the risks associated with secondhand smoke.

Seek Online Support

There is a lot of online resources available to help your quitting journey, including the NHS’ Better Health hub. Here, you will be able to find a series of guides and information on addiction.

Remember Why You’re Doing It

When trying to quit smoking, always remember the reason why you’re doing it. Whether looking to improve your health, increase your fertility chances, or protect an unborn child, keep these “goals” in mind at all times. This should help you to stay on track and see the bigger picture.

Still Struggling To Get Pregnant? We Can Help

If you’ve been struggling with fertility for quite some time and have made good progress with your quitting journey, it might be time to reach out to a fertility expert. Smoking addictions can increase the chances of needing fertility treatment like IVF, which is something we offer at Fertility Plus.

Do not hesitate to get in touch to discuss your concerns and options further. We are here to help, no matter the circumstances.

IUI Timeline: What Happens During IUI Treatment?

Before starting any form of fertility treatment, it’s important to know exactly what to expect. If you are considering (or have been recommended) IUI treatment, this guide will provide a great place to start your journey. Read on to discover exactly what IUI treatment is, including the processes and timeline involved with it.

What Is IUI?

Intrauterine insemination (IUI) is a form of fertility treatment that involves placing sperm inside a woman’s womb. The main aim is to increase the chances of fertilisation due to allowing more sperm to reach the egg. During IUI treatment, the sperm will either come from your partner or sperm donor, depending on your situation. 

What Happens During IUI Treatment?

To put it simply, IUI involves separating fast-moving sperm from slow or non-moving sperm. The semen comes from masturbation and the separation process is carried out in the laboratory. Once the sperm has been collected, it is placed into the women’s uterus, as close as possible to the time of ovulation.

Read on to discover more about the IUI timeline. Here, you will learn what to expect before and during treatment.

Before Treatment

Before undertaking IUI, you will need to have a consultation with a fertility specialist. This will help to ensure that you understand what the treatment entails and also helps to ensure that the treatment is right for you. This will further be confirmed through a range of fertility tests, as part of the IUI timeline.

Fertility tests are important to carry out. This is because there are some circumstances in which IUI might not be the best option. Your consultant will outline these to you before offering the treatment.

Timing Treatment

Once it has been agreed that IUI is the best fertility treatment for your situation, the planning will begin. For the best chances of IUI success, your IUI cycle should begin around 12 to 16 days before your next period. This is usually the time in which a woman ovulates.

Of course, menstruation varies between individuals (particularly those with an irregular menstrual cycle). Your fertility specialist may give you an ovulation prediction kit (OPK) to assist here.

During this pre-treatment stage, you might be offered one of the following:

Natural IUI Cycle

Natural IUI is the most common and simple form of IUI. It follows the same process as stated above, following the pattern of your natural menstrual cycle. This form of IUI is most suited to those with regular cycles.

Stimulated IUI Cycle

If you have irregular menstrual cycles or struggle with other ovulation-related issues, you might be offered stimulated IUI. With a stimulated IUI cycle, vaginal ultrasound scans will be conducted to track the development of your eggs. Once the egg is mature, you’ll be given a hormone injection. This injection stimulates the release of the egg, allowing for the rest of the IUI treatment to be carried out as normal.

During Treatment

As IUI focuses on injecting sperm into a woman’s womb, it’s important to ensure that the sperm is strong. If you have a partner that’s able to donate sperm, then they can do this for you. If not, you will have the option to use donated sperm.

Using Your Partner’s Sperm

If you decide to use your partner’s sperm, they will need to masturbate into a specimen cup on the day of treatment. Once collected, the sperm will be filtered, resulting in a concentrated pool of “healthy” or “strong” sperm.

Using Donor Sperm

No matter your sexual orientation or relationship status, frozen sperm from a donor can be used during IUI. This sperm is usually frozen for six months prior to ensure that it is free from any infection or disease.

The Process

When the sperm is ready, a speculum is inserted into the vagina to keep it open. A catheter will then be guided into the womb – the sperm sample will pass through this. The insemination will take no longer than a few minutes and is usually painless.

We will advise you to take a 15 to 20 minute rest before heading home.

IUI Success Rates

There are a lot of factors involved when it comes to determining IUI success rates. One of the main ones is a woman’s age. For women aged under 36, the clinical pregnancy rate sits at 10 to 12% per treatment cycle.

For full clarity and confidence, it’s best to speak to your fertility specialists to discuss both risks and success rates.

Final Notes

Compared to other fertility treatments, IUI involves a really quick procedure that takes just minutes to complete. If you wish to know more about intrauterine insemination or want to discuss your options further, do not hesitate to get in touch with our specialists today.

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