ICSI question

racheyt0227

I guess I was under the assumption if you do ICSI then all mature eggs would fertilize, but I see in peoples stats that is not always the case. Why is that?

joules12

I've been curious about that and have assumed inferior egg and/or sperm quality.  Out of 4 mature eggs, we had only one fertilize (all ICSI'd).  Because I'm currently in beta hell, we cancelled our WTF appointment so I have yet to ask my RE about it.  I'm interested to see what others respond.

racheyt0227

Thanks. I'm curious too. When I spoke to my RE about it I was pretty sure she said all mature eggs would fertilize.

SweetDahlia

Totally not true. I would love an answer. I had 11 mature eggs and only 4 fertilized today.

jessican08

We had 19 mature eggs and ICSI'd all of them but only 9 fertilized normally. We haven't met with our RE yet to discuss our cycle but I'm guessing the others didn't fertilize either because of an egg quality issue or because something was genetically wrong with the sperm. 

I've heard that sperm quality issues are more often found after day 3 which might explain why we still had 9 growing on day 3 but by day 5 we only had 2 blasts - the rest were all behind and none made it to freeze.

ladyrader0227

We had 4 eggs at retrieval & only 2 fertilized (all were ICSI).  My RE said that some just don't make it past day 1 for unknown reasons.  I'm going to ask again during my beta #1 appointment tomorrow.  Our ET was on Sunday, March 11.

MandaS08

To kind of tag on to this question-if you don't have MFI should you ICSI to get a higher fert rate?  Or would the eggs that wouldn't fert without ICSI (without MFI) be "bad eggs" anyways? 

I would think if you ICSI's and it didn't fertilize there was probably something wrong with the egg or the sperm?

genmalone

MandaS08:

To kind of tag on to this question-if you don't have MFI should you ICSI to get a higher fert rate?  Or would the eggs that wouldn't fert without ICSI (without MFI) be "bad eggs" anyways? 

I would think if you ICSI's and it didn't fertilize there was probably something wrong with the egg or the sperm?

My clinic uses ICSI as almost a standard with IVF.  We don't have MFI but we still did ICSI.  We had 27 retrieved and 23 fertilized but I'm not sure how many were mature.

My RE said the fertilization rate is higher with ICSI.  It isn't required but is definitely encouraged at my clinic.

winofairy

I read that the fertilization rate per egg using ICSI is about 70-80%.  And the ones that don't fertilize have either an egg/sperm quality issue.

We will be doing ICSI due to my age of 40.  My RE said that the outer layer of the egg gets harder to penetrate as you get older. 

solarflare

genmalone:

MandaS08:

To kind of tag on to this question-if you don't have MFI should you ICSI to get a higher fert rate?  Or would the eggs that wouldn't fert without ICSI (without MFI) be "bad eggs" anyways? 

I would think if you ICSI's and it didn't fertilize there was probably something wrong with the egg or the sperm?

My clinic uses ICSI as almost a standard with IVF.  We don't have MFI but we still did ICSI.  We had 27 retrieved and 23 fertilized but I'm not sure how many were mature.

My RE said the fertilization rate is higher with ICSI.  It isn't required but is definitely encouraged at my clinic.

The clinic I am going to only uses ICSI, but the other clinic I consulted with who uses ICSI 50% of the time said that because there are so many sperm placed in this artificial environment it is not uncommon that 2 sperm will penetrate one egg (w/o ICSI) and then they have to discard those eggs. So you may have to throw away some chances. With a lot of eggs this is prob not that big of a deal, but for us slightly older ladies, it's not necessarily the best idea.

Mitzi Bishi

Don't forget there is a bit of nature still left in this... I think since we know things are being fertilized it is difficult to understand sometimes they simply don't work, which is sort of like insurance against genetic defects. It could be a wonky sperm or an egg issue.

It's also kind of like why some fizzle out early or lose that spark of life or don't make it to day 3 or 5. Unfortunately it's quite expensive to run tests, so doctors tend to chalk it up to the dreaded "sometimes this just happens" and the earlier the less they can explain why.  

There's no real way to know how many people without ART get pregnant and never realize it / lose a very early pregnancy, but I've seen figures that say it's quite high. That's the pain in all of this... you know so early and it makes the waiting that much more difficult. 

You may also want to read about epigenetics. It's really fascinating! 

annalisel

I tried to ask about this at our WTF. Our RE said 70% is a normal fertilization rate with ICSI. I tried to ask about whether that number is impacted by MFI since only people with MFI use it, but she said that includes people without MFI who are doing it for other reasons, for instance having low numbers of eggs to work with.

You'd think there is enough data out there to compare fertilization rates by ICSI across diagnoses. Odd that no statistician has looked into it? 

racheyt0227

Interesting! Thanks for the responses everyone. Glad I realized this now instead of maybe being disappointed when the time comes.

maggie2324

Besides everything that was mentioned 5-10% of eggs are damaged during ICSI. 

When they select the sperm, they only look for Kruger criteria declaring it normal. The sperm may still have an abnormal nucleus. There is new technology to look at the nucleus and fertilization rates are higher when using this.

Obviously, it could also be the egg. 

mslady919

I wish that was the case but no it is not. It just gives them a better chance by not forcing them to swim around looking for the egg. They still have to do there part to fertilize.

lkmiss

I just went through an ER with 17 retrieved. 14 were mature and 2 were matured in the lab. We used a newer technique called PICSI due to severe MFI, which I believe has a 99% rate of selecting healthy sperm without DNA damage and more closely simulates what would happen in natural selection. Well, we ended up with only 4 fertilizing normally, which is less than a 30% rate. My clinic typically has an 80% fert rate with just ICSI.  We are still waiting to see if they make it to blast and to do PGD to see if any are normal. According to the embryologist, it is more than likely poor egg quality and not the sperm in our case of such poor fertilization.

So hard to know if it's simply my over 40+ age or if the protocol would make a difference in egg quality...sigh.