IUI, IVF, ICSI: a gentle glossary for when the clinic starts using letters

Somewhere between the second and third appointment, the conversation often changes. The doctor stops talking about tests and starts talking about treatment, and suddenly there are letters everywhere. This glossary will not tell you which path is right for you. That is a conversation for you, your husband or partner if you have one, your doctor, and God. But it may help the words feel less like a foreign language.

The simpler steps

Timed intercourse

Sometimes the first step is simply tracking ovulation more closely, often with scans, so you know your most fertile days. It sounds small, but for some couples it is enough.

Ovulation induction

If you do not ovulate regularly, for example with PCOS, your doctor may suggest tablets or injections that encourage your ovaries to release an egg. You will usually be monitored with scans, partly to watch for more than one egg developing. Never take ovulation medicines without medical supervision.

IUI: intrauterine insemination

In IUI, sperm is washed and concentrated in the lab, then placed directly into the womb through a thin, soft tube around the time you ovulate. It feels similar to a smear test and takes a few minutes. It may be done in a natural cycle or with medication. IUI is sometimes offered for unexplained infertility, mild sperm issues, difficulties with intercourse, or for women using donor sperm.

IVF: in vitro fertilisation

IVF has several stages. It helps to know them in order:

1. Stimulation. Daily hormone injections, usually for around one to two weeks, encourage several eggs to grow. You will have regular scans and sometimes blood tests.
2. Trigger. A final injection, timed precisely, helps the eggs mature.
3. Egg collection. Under sedation, a needle guided by ultrasound collects eggs from the ovaries.
4. Fertilisation. In the lab, eggs and sperm are brought together.
5. Embryo development. Embryologists watch the embryos for a few days.
6. Embryo transfer. One embryo (sometimes more, depending on your situation and local rules) is placed in the womb through a thin tube.
7. The wait. About two weeks later, a pregnancy test.

ICSI: intracytoplasmic sperm injection

ICSI is a form of IVF where a single sperm is injected directly into each egg. It is often used when there are concerns about sperm count or movement, or when fertilisation has been difficult before.

Other words you may hear

• FET (frozen embryo transfer): transferring an embryo that was frozen in an earlier cycle.
• Blastocyst: an embryo around five or six days old.
• OHSS (ovarian hyperstimulation syndrome): an over-response to stimulation drugs. Your clinic will tell you the warning signs, such as a swollen, painful tummy, feeling sick, or breathlessness. Call them straight away if you notice these.
• Donor eggs or sperm: using eggs or sperm from a donor.
• Luteal support: medication, often progesterone, given after transfer.

Questions worth asking any clinic

• Which treatment do you recommend for us, and why?
• What are your results for people in a similar situation to ours?
• What is included in the price, and what costs extra?
• How will you support us emotionally, and is counselling available?

Faith and the questions treatment raises

Many Christian couples wrestle with questions about treatment: how many embryos to create, what happens to any that are frozen, costs, and how far to go. These are real and worthy questions. Christians land in different places on them. Take your time. Talk honestly with each other, pray, and if it helps, speak with a trusted pastor or Christian counsellor as well as your clinic. You are allowed to ask the clinic detailed questions about their practices before you begin.

Whatever you decide, treatment is not a test of your faith, and choosing it or not choosing it does not make you more or less trusting of God. He says to the anxious heart, “Fear thou not; for I am with thee” (Isaiah 41:10). That is as true in the stimulation phase as it is in the quiet months of trying naturally.

A prayer for the decisions ahead

Lord, the choices in front of us feel big. Give us wisdom, unity and peace as we weigh them. Guard our marriage and our hearts, and help us to remember that our worth and our hope rest in You, not in any procedure. Amen.