Table 1 Schematic list of major procedures for treatment of infertility
Indication | Success rate | Advantages | Disadvantages | |
|---|---|---|---|---|
IUI | - Unexplained infertility | variable: ~15-20 % | - Very simple procedure | Virtually no disadvantages |
Factors reducing the success rate: | ||||
- High concentration of motile sperms | ||||
- Older age of the woman | ||||
- Mild/moderate male infertility | ||||
- Poor egg quality | ||||
- Poor sperm quality | ||||
- Cervical factor infertility | - Severe endometriosis | |||
- Severe damage to fallopian tubes | ||||
- Blockage of fallopian tubes | ||||
- Minimal endometriosis | ||||
IVF | - Unexplained infertility | ~30 % of all treatment cycles (depending on the age of the woman) | - Treatment of choice with donor eggs | - Multiple pregnancies |
- Low sperm numbers or motility | ||||
- Reduce surgery on damages tubes | ||||
- Infrequent or absent ovulation | ||||
- Tubal factor infertility | ||||
- Cervical factor infertility | ||||
- Immunological factor infertility | ||||
- OHSS. | ||||
- Ectopic pregnancy | ||||
- Moderate or severe endometriosis | - Painful treatment | |||
- Expensive treatment | ||||
- Age-related infertility | ||||
- Failure of other fertility treatments | ||||
ICSI | - Low numbers of motile sperm | variable: ~8.5 % to 33.5 % (age range between 35 and 44) | - Overcomes male infertility | - Higher risk of miscarriage |
- Abnormal morphology sperm | ||||
- Efficient where few eggs are available | ||||
- High levels of antisperm antibodies | ||||
- Success depends on different factors (age of female, quality of eggs, sperm, uterus) | ||||
- Prior or repeated fertilization failure | ||||
- Limited frozen sperm | ||||
- Obstruction of the male tract sperm | ||||
- Painful treatment | ||||
- Expensive treatment |