Natural cycle IVF is done without any hormone medication with the aim to collect naturally growing egg from the ovaries . Advantage

• It can be used for woman who want ‘Drug Free IVF’.

• It is cost effective in terms of medication cost

Drawback :

• Risk of natural ovulation inside body before oocyte retrieval.

• Low success rate as usually only 1 egg is collected.

• It has a very high chance of cancelled treatment due to no egg retrieved at time of OCR .

In modified natural cycle IVF minimum medication are given to help collection of naturally growing eggs from the ovaries.

Advantage:

• It can used for woman who wish to take minimum possible medication.

Drawback :

• Low success rate as usually only 1 or 2 oocytes are collected.

In Mild IVF low doses of fertility medicines are given for 5 to 10 days to promote growth & collection of 2-5 eggs.

Advantage:

• It can be used for women with low ovarian reserve, where ovaries can produce 2 to 5 eggs despite maximum those of fertility medication.

• So, choosing for mild IVF in such cases reduces cost of medication & also emotional burden of the treatment.

Drawback :

• Lesser success chance per started cycle as lesser number of oocytes & embryos are available.

Normally a matured oocyte called Metaphase 2 ( M2 ) oocyte is released from ovary at the time of ovulation. Similarly, during routine IVF procedure matured oocyte is collected from the ovaries.

In IVM process immature eggs ( Germinal vesicle & metaphase1 ) are collected from the ovaries & then matured inside incubator in embryology laboratory. This is why it is called In Vitro Maturation ( IVM ).

In Vitro Matured egg is then used for ICSI.

Advantage:

• It can be used for women with Polycystic Ovarian Disease to avoid risk of ovarian hyperstimulation.

• Women who want fertility preservation before starting treatment for cancer, but have very limited time ( only few days ) can opt for IVM of oocytes & IVF/ICSI.

Drawback :

• It has lesser success per started cycle as compared to conventional IVF. .

In IVF & ICSI both processes semen sample is processed to separate healthier fraction of sperms .

During IVF process sperms are incubated overnight in culture dishes with aspirated mature oocytes . Here fertilization takes place naturally.

ICSI is advanced modification of IVF .

During ICSI each oocyte is held & injected individually with selected sperm by trained embryologist . That is why the term ICSI- Intra Cytoplasmic ( oocyte cytoplasm ) Sperm Injection is used

ICSI is preferred over IVF in following cases :

• Woman with low number of eggs.

• Men with very low number of sperms.

• Men with poor sperm quality.

• Men with poor sperm motility.

• Men with perm retrieved after TESA / micro TESA in cases of azoospermia.

• Couple with previous partial or total fertilisation failure.

• Couple using frozen sperms.