Assisted Reproductive Treatments: What Each One Does

Assisted reproduction covers a small number of core treatments and several additions to them. The treatments are IUI, where prepared sperm is placed into the uterus; IVF, where eggs are collected and fertilized in the laboratory; and ICSI, which is IVF with a single sperm injected into each egg. Alongside them sit surgical sperm retrieval, frozen embryo transfer, and egg freezing for preservation. Genetic testing of embryos is an addition rather than a treatment. Which applies depends on your diagnosis, not on which sounds most advanced.

IUI

Prepared sperm is placed directly into the uterus around ovulation, shortening the journey. Fertilization still happens inside the body, so IUI requires at least one open fallopian tube and enough motile sperm.

Used for: mild male factor, ovulation problems combined with ovulation induction, unexplained infertility, cervical factors and donor sperm. It is simpler and cheaper than IVF with a lower chance per cycle.

IVF

The ovaries are stimulated, eggs are collected, and they are combined with prepared sperm in the laboratory. Embryos are cultured for five to six days and one is transferred; others may be frozen.

Used for: blocked fallopian tubes, endometriosis, unexplained infertility, ovulation problems that have not responded to simpler treatment, and where IUI has not succeeded.

ICSI

Identical to IVF except that an embryologist injects one selected sperm directly into each egg, rather than leaving fertilization to occur.

Used for: significant male factor, sperm retrieved surgically, or previous fertilization failure. It is not a general upgrade: where there is no male factor, the ASRM committee opinion finds that routine ICSI does not improve live birth rates and it costs more than conventional IVF.

Surgical sperm retrieval

Where there is no sperm in the ejaculate, it can often be collected directly from the epididymis or testicle through PESA, TESA or TESE, and used with ICSI.

Freezing and frozen transfer

Eggs, sperm and embryos can all be frozen. Embryos not transferred in a cycle are frozen for later, which is what makes single embryo transfer practical: choosing one now does not forfeit the others. Egg freezing preserves eggs at the age they were collected, either by choice or before treatment that may affect fertility.

Note what freezing does and does not do. It preserves; it does not improve. Eggs frozen at 38 are eggs from a 38 year old whenever they are used.

Genetic testing of embryos

PGT-M tests embryos for a specific single-gene condition known in the family. PGT-SR tests for a known structural chromosome rearrangement. Both test for something already identified.

PGT-A is different: it screens chromosome number. The HFEA rates it red for improving the chance of having a baby for most patients and notes it may reduce that chance by reducing the embryos available for transfer, while rating it green for reducing miscarriage. Our article on whether to have PGT-A covers the evidence by patient group.

How is the right treatment chosen?

By assessment of both partners, not by preference. Hormone testing, a semen analysis, imaging and history determine which of these applies. The order generally runs from the least invasive option that could work upward, with age shortening the time spent at each step.

We at Millennium IVF Clinic will explain which applies to your results and why. You can arrange a consultation with our team, and our costs page sets out pricing.

Frequently asked questions

Which treatment has the highest success rate?

The question does not have a single answer, because they address different problems. Success depends far more on age and diagnosis than on which technique is used, and the treatment with the highest headline rate is not automatically right for you.

Is ICSI better than IVF?

Only where there is a male factor or previous fertilization failure. Otherwise ASRM finds no improvement in live birth rates from using it routinely.

Do I have to start with the simplest treatment?

No. Where there are blocked tubes, severe male factor or diminished ovarian reserve, starting with IUI would waste time. The sequence follows the diagnosis.

Does egg freezing reduce the risk of genetic problems in a baby?

No. Freezing preserves eggs as they are. It does not change their chromosomal status, which relates to the age at which they were collected.