Cross-Post: ICSI?

Davie813 · December 2014

**Ticker Warning**

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!

ronniesgirl1981 · December 2014

Split the difference and do 1/2 and 1/2? FWIW my first clinic did not do ICSI unless it was medically necessary, but both of my second opinion clinics said ICSI was a must.

kristyn831 · December 2014

We did ICSI. I wasn't willing to go through all the stimming, etc. with low risk of getting anything fertilized. The risk of birth defects is still very low. If you do half ICSI and half conventional IVF, just be comfortable that many eggs may not fertilize. I had 17 mature, 15 fertilize, transferred one of the 15, and 7 made it to frost. So even though we did all ICSI, only 8 of the 17 made it.

stace2524 · December 2014

We did 1/2 and 1/2 due to the fact that we had never gotten pregnant before. Glad we did, out of the 4 high quality blasts, 1 was traditional IVF and 3 were ICSI.

tptbabe · December 2014

We did ICSI for our last cycle (and will do PICSI for our next) because we have severe MFI. Half and half would be a good compromise if you were to get alot of eggs, but I'd be wary of doing it if you had less than say, ten? (Ambiguous number I just pulled out of my ass.) Is it something that you could discuss with a therapist beforehand? You definitely both want to be on the same page.

Cindal · December 2014

We did ICSI in our mini-ivf and will have to do it again in any future cycles due to our severe male factor. The added risk of birth defects is actually very low but vastly improves fertilization rates.

KM721 · December 2014

I am all for ICSI. We were told we pretty much had to do it due to my husband's low morphology. Even if you get decent fertilization without it, your numbers can really drop when it comes to transfer, so just be aware of that.

emmuffy · December 2014

We did it because we knew I would be a Low responder and wouldn't have many eggs to work with. I've seen unfortunate results on this board from other ladies who didn't have any eggs fertilize, and ICSI increases the odds of fertilization. You could do half and half, and if you get enough good embryos from the non-ICSI group, you could just choose to use those ones. GL

katers79 · December 2014

We did ICSI on all because did PGD. I'm glad we did it -- we wanted to optimize the cycle, had good fertilization numbers.

BootsOrHearts · December 2014

**siggy warning**

You can wait and see how many eggs you get and decide from there. If you get a high number, you can afford to not have a large number fertilize. If you get a low number though, you might want to do it to help ensure you get enough embryos to transfer. We only retrieved 7 mature eggs and we did ICSI and got 5 embryos so it was worth it.

Also if your husband has low sperm quality/quantity, they may recommend it to improve fertilization rates.

Sha259 · December 2014

We did PICSI, but not because we were doing IVF, but because we had an MFI issue. Personally, I would not have spent the extra $500 on it unless we had a reason, which we did.

Every procedure comes with risks, even traditional IVF, and I don't believe that the risk factors are substantially greater with ICSI than without.

I wonder why he would feel that ICSI is more artificial? If anything, it is picking the best of the best of his sperm to do the job. Think of it as an aptitude test for sperm. Only some will make the cut!

Good luck with your decision.

Davie813 · December 2014

Sha259 said:

We did PICSI, but not because we were doing IVF, but because we had an MFI issue. Personally, I would not have spent the extra $500 on it unless we had a reason, which we did.

Every procedure comes with risks, even traditional IVF, and I don't believe that the risk factors are substantially greater with ICSI than without.

I wonder why he would feel that ICSI is more artificial? If anything, it is picking the best of the best of his sperm to do the job. Think of it as an aptitude test for sperm. Only some will make the cut!

Good luck with your decision.

I think he feels like the selection process itself is artificial and like it would be more of an "aptitude test" to let them fight it out the old-fashioned way.

Thanks for the insights, everyone. They really helped! I've let DH know what people generally have to say, and he's more flexible now. I'm calling the RE to discuss it with her further today.

I didn't know 1/2 and 1/2 was an option. I'm not expecting to get a huge number of eggs due to age and reserve issues, but it's nice to know that's a possibility if some kind of miracle occurs.

Dyork · December 2014

We aren't doing ICSI for our 1st round. Both MH and I are under 35, we're not dealing with MFI at all, and my RE would rather try one round and see if they self fertilize. If we do end up doing it for the next round insurance won't cover the cost of ICSI so we'd have to pay for it OOP, which is fine and I really can't complain. But we figured we'd go through the first round and see what happens.

doves654 · December 2014

I would definitely do 1/2 and 1/2. I just did and was shocked when all of the non-ICSI eggs didn't fertilize. It was very good (and stressful!) information to have.

lilycakes78 · December 2014

I am pro-ICSI as well! I actually asked the same question on this board when I started IVF. I wasn't sure we needed it because DH's sperm count was only borderline low. The responses I got really made me rethink skipping it. It is possible to have zero eggs fertilize and I didn't want to take that risk. Also, someone else mentioned that while their husbands counts are good, her age caused her eggs to be tougher to penetrate.

We had 5 mature eggs and all 5 fertilized with ICSI, so it's definitely something to consider. We were going to do half and half but I only had 5 eggs so we did all and I'm glad we did.

Hope this helps!

vpine · December 2014

Siggy warning.... My Dr does ICSI for everyone going through IVF. I recommend it because there's higher success fertilization rates. In my case, 11 eggs were retrieved, all fertilized, all made it to 5 day blasts.

CRMhoney · December 2014

If the boys aren't doing their jobs and fertilizing the eggs then the embryologist should use ICSI. The sperm are given the chance to do it naturally at first, but if they can't or won't then ICSI is used (this happens more than you would think). Its seems like a big waste of time if you aren't willing to fertilize at all costs any way possible. At least thats what they do at my clinic. If there are chromosomal issues the eggs could still fertilize naturally and then m/c later. ICSI doesn't raise the birth defect rate. Some mens swimmers just need a little nudge. With PGS at my clinic ICSI is mandatory so they can choose the best looking sperm.

Davie813 · December 2014

Thank you so much for sharing your experiences, all. I had another consult with the RE today, and while we'll make a final decision after retrieval, I'm leaning toward just doing ICSI. Maybe 1/2 and 1/2 if I have an unexpected bonanza of eggs.

Again, I really appreciate everyone's input!

jnissa · December 2014

You know, one thing you may want to consider (and something my RE told me that was great advice) was not to wait until after your ER to make a decision. That's going to be an emotionally charged time and there's a huge chance for surprises both positive and negative in terms of what they're able to retrieve that's mature. It's not a time when you want to potentially not be immediately on the same page with your partner, and in the moment of emotion and having to make a decision he may retreat to a safe space of no ICSI and you may feel even more passionately about doing it. You may be reacting to the hormones by that point and have a harder time thinking clearly Draw a hard line like >10 is natural and <10 is ICSI and go in knowing what you want.

For the record, we did ICSI. It's the standard protocol at our clinic for anybody over 38.

Davie813 · December 2014

jnissa said:

You know, one thing you may want to consider (and something my RE told me that was great advice) was not to wait until after your ER to make a decision. That's going to be an emotionally charged time and there's a huge chance for surprises both positive and negative in terms of what they're able to retrieve that's mature. It's not a time when you want to potentially not be immediately on the same page with your partner, and in the moment of emotion and having to make a decision he may retreat to a safe space of no ICSI and you may feel even more passionately about doing it. You may be reacting to the hormones by that point and have a harder time thinking clearly Draw a hard line like >10 is natural and <10 is ICSI and go in knowing what you want.

For the record, we did ICSI. It's the standard protocol at our clinic for anybody over 38.

That is a very good point. ICSI is the standard at our clinic, too (regardless of age), and I do trust our doctor. It really might be better to just agree beforehand to have it done...

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