Cross-Post: ICSI?

Davie813

So my husband and I are currently making the many, many decisions that go along with our first IVF cycle, and we're just kind of stuck on a few things.

He's adamantly opposed to having ICSI done under any circumstances (he's worried about birth defects, and he's honestly not completely comfortable with IVF in the first place, so ICSI makes it seem even more "artificial" to him.)  I would prefer to have it done, but only if the eggs weren't fertilizing on their own.

If you don't mind sharing, did you/will you do ICSI?  Why or why not?

Thanks!

fuzzbumble

We've been debating as well.  It is so hard, I feel like I'm gambling with all this stuff.  Do we do ICSI, PGD, assisted hatching, and they are all little add-ons at a fee.  

My gut feeling right now is that we have no reason to believe the eggs won't fertilize, it should be ok.  The sperm have reached egg three times for us within my body, they should be able to figure stuff out when they're placed right next to the egg.  Plus it is $2000...

PGD freaks me out in that they actually remove a cell from this thing that only has 4-6 cells.  My RE says it doesn't hold much of a risk, but he also said IUI quadruples the live birth rate and I have a 75% chance of IVF working first go....

pettycrocker

Umm.. well I've done 3 fresh cycles. The first cycle we did half icsi / half "natural" in that cycle ONLY the ICSI eggs fertilized. I don't think it's because H's sperm was defective either because the ICSI eggs all did beautifully on that cycle and the subsequent cycles. So, do you want to risk possibly blowing your entire IVF cycle by skipping a step that is fairly low in cost and increases the chances of your eggs fertilizes exponentially? That's the question you have to ask yourself. 

Keep in mind "natural IVF" is far from NATURAL. Sperm and eggs are placed in a petri dish to fertilize and they don't always get it done, because they weren't meant to do that shit in a petri dish- ykwim? 

So my 2 cents is- 100% always do ICSI, add AH if you can, because that increases your odds of successful implantation, if you are AMA and / or have had multiple losses, definitely go for the PGD.  

Good luck. 

FWIW We've gotten pregnant on our own twice, once was our daughter, and the 2nd was my 2nd ectopic- SO like Fuzz theorized, we know sperm meeting the egg is not the problem even in a difficult setting (jacked up tubes) they still got it done, but even fucked up tubes are a natural environment. So do keep that in mind when you are both making your final decisions. 2K (or however much they charge) will seem like pittance if you have a failed cycle due to lack of fertilization.  

fuzzbumble

That is a very good point, potato, and one my husband has talked about.  If we're going to do it, do it all.  

bumpuser6119831

We did ICSI last time and will be doing it again and we have a perfect 2.5 year old boy. What ever it takes to get this to work we will do it. For the record we also had AH last time as well and this time we will be doing the testing.

Davie813

Thanks, all, and good points.

Actually, finances aren't part of DH's objection at all. Like I said, he's not happy about IVF in the first place, and he has this idea that if the sperm/egg don't do their thing w/o help, there's probably something wrong with them and we shouldn't force it. The point about conditions in the Petri dish not being like conditions in the body is a good one, and I'll bring it up to him.

Actually, all the feedback I've gotten says do icsi, and I'll be bringing that up with him, too.

Thanks again!

JBDamonM

My clinic always does ICSI - so it wasn't up for debate. Good luck

MoFree

We did ICSI for both IVF cycles. One of our issues is severe MFI so ICSI was not optional. We have a perfectly healthy 2 yo.

Jodee37

ok so this was my thinking:

why would i spend boat loads of money (i'm 100% OOP) on this whole process and take the chance that some eggs won't fertilize (or that 2 sperms will fertilize 1 egg) and we would lose some chances of embies??? made 0% sense to me. we don't have a male issue but we weren't willing to risk doing anything that would reduce our chances of the most embies.

it happens in coincubation. 2 sperms can fert 1 egg and you lose that one. or perfectly good sperm can sometimes NOT fert an egg. 

also, my RE made it quite clear that IVF does not increase the chances of birth defects. AT ALL. maybe find some research supporting this and show it to him?

also... if YH has an issue with ICSI being "Artificial" he has something coming to him when you start this process.... the WHOLE THING is artificial. the multitude of shots. mock transfer. multitude of blood draws and u/s. the retrieval. allllll of it. i hope he can come to terms with these feelings before you start this... i would hate for him to resent any part of this. you guys needs to be a team here.

Davie813

Jodee37 said:

ok so this was my thinking:

why would i spend boat loads of money (i'm 100% OOP) on this whole process and take the chance that some eggs won't fertilize (or that 2 sperms will fertilize 1 egg) and we would lose some chances of embies??? made 0% sense to me. we don't have a male issue but we weren't willing to risk doing anything that would reduce our chances of the most embies.

it happens in coincubation. 2 sperms can fert 1 egg and you lose that one. or perfectly good sperm can sometimes NOT fert an egg. 

also, my RE made it quite clear that IVF does not increase the chances of birth defects. AT ALL. maybe find some research supporting this and show it to him?

also... if YH has an issue with ICSI being "Artificial" he has something coming to him when you start this process.... the WHOLE THING is artificial. the multitude of shots. mock transfer. multitude of blood draws and u/s. the retrieval. allllll of it. i hope he can come to terms with these feelings before you start this... i would hate for him to resent any part of this. you guys needs to be a team here.

1.  Oh, wow.  I had never heard of that.

2.  I know.  I'm not sure what to do about this.  It's weird--he was totally on-board with IUI with injectables (and all the accompanying blood tests, ultrasounds, and the like), which really isn't my idea of natural, either.  Something about the petri dish part just freaks him out.  He is supportive, and does want DD to have a sibling, but he's definitely only going as far as IVF because I want it so much.  That does make me sad. 

That said, I did share with him last night what people had been telling me, and he's now much more open to the idea.  I go in for monitoring tomorrow, and I'll request additional consultation with the doctor on this issue.  He's agreed to do whatever she recommends.

shauna78

When we first started talking to our RE about IVF, I assumed we would have to do ICSI.  Particularly because my husbands SA revealed really low morphology (1%).  However, my doctor actually convinced me not to.  He showed us data that there is an increase in miscarriage rate when ICSI is used (not to mention the other birth defect possibilities). He said - why do it, if you don't need it?

You might want to look into the Sperm Penetration Assay test.  It measures whether or not the sperm can penetrate an egg.  Even though my husband had low motility and horrible morphology his test results from this test were great. We ended up doing traditional IVF and 12 out of 14 eggs fertilized!  If the Assay test had revealed something else we would have chosen ICSI. 

Anyways - just my two cents. 

pettycrocker

I can attest to the 2 sperm 1 egg thing, that was part of why we had nothing fertilize in that half natural cycle, I think 2 of 4 were because of multiple sperm, the other 2 did nothing in the petri dish. 

efhoping2010

We have to use ICSI because of DH's dx.

We also need AH because of DOR.

And I wish that CCS and PGD would have been suggested or even offered for our previous IVF cycles as we have wasted so much $$$ on transferring nonviable embryos.

If we cycle again we will utilize everything possible even though we are 100% OOP.

Good luck with your decisions.

Jodee37

FYI ladies PGS/PGD cannot guarantee a viable preg. it also cannot guarantee 100% that an embie deemed "chormosomally normal" is in fact normal. and on the flip side it can mistakenly deem a perfectly good embie as "abnormal." 

be a wise consumer and do your research.

(getting off my soapbox now.)

Jodee37

Jodee37 said:

FYI ladies PGS/PGD cannot guarantee a viable preg. it also cannot guarantee 100% that an embie deemed "chormosomally normal" is in fact normal. and on the flip side it can mistakenly deem a perfectly good embie as "abnormal." 

be a wise consumer and do your research.

(getting off my soapbox now.)

on second reading i see this may come off as harsh. i truly meant it to be a meaningful suggestion. many times clinics push PGS/PGD on women who don't need it (there is no history of genetic issues, or this is their 1st IVF cycle, etc, or women with DOR who won't respond well to IVF and have limited # of embies). i just think it's smart to read the current research out there before agreeing to it. that's all. 

fuzzbumble

Jodee, we looked into it all after you said that last time, and we decided against it. When we tell the RE, then he comes out with his statistics that PGD doesn't improve the chances in my age group. But he would have let us do it if we had wanted..