ICSI

[CH91]

Hello girls I've just found out me and my partner are going through the ICSI treatment I was wondering if anyone has already been through this and what is the plan they use? ( like what happens stage by stage )

Any replies I'd be grateful

Xxxxx 💞

[Sam101]

Hi ch91. My husband and i have been through icsi treatment, 2 cycles to be exact. Both times we had the long protocol which means you start medication to help produce lots of eggs. You will have regular scans to check how you are doing. Once you have a good amount at a good size they will give you a trigger inj which helps mature the eggs ready for the collection. You will have sedation for your collection as it is uncomfortable on the same day your other half will give their sperm sample for your eggs to be fertilised and then a few days later your embryologist will ring you to let you know how they have got on so you know how many you have to use. They will then arrange your transfer day and that is far less painful. They pass a catheter into your uterus and then another catheter with your embryo on to transfer into your uterus. After this you carry on with your meds and startyour 2 week wait. Then you do your test and hope you are lucky!!

Hope this makes sense, i dont think i have missed anything out but if i have im sorry. Good luck x

[katya38]

Hi there. I've just been through it and it was far better than I thought it would be. The emotional side is by far the worst bit. The physical side was fine and nowhere near as bad as it's made out to be. It's likely to be more successfull than regular ivf as they insert the sperm into the egg. I didn't find the egg collection sore as they Just knock you out. When you do the egg transfer you get to see the embryo up on the screen which is exciting but sadly ours failed. The 2 ww is definitely the most brutal xx

[Kat9lives]

Hi I had 1 cycle normal IVF and the 2nd cycle ICSI. You start with a consultation at ypur clinic... then give blood and discuss the different options. Im presuming youre at thos stage having decided you're having ICSI?

Mine was ICSI short protocol. The difference between long and short protocol is just how your doctor thinks you'll react to your drugs... both are given drugs to stimulate lots of eggs. The long is a longer lead in and you take meds before starting stims (injections) the short you start straight onto stims (after your period or taking a pill to induce a period).

ICSI and IVF are the same up to egg collection which is explained later...

Stim phase....I took 2 types of injections... on the short protocol over about 2 weeks, twice a day. One stimulates the production of eggs and one regulates this so that you don't produce too much too quickly. Every few days you have a check up with the doc who scans you (completely pain free by inserting a probe vaginally with a camera in the end...you'll get used to these!!) to see how many eggs are developing (or rather how many follicles are on your ovaries and each follicle has the potential but not guaranteed to produce one egg). He will up and down your dose of stims to finely balance how many eggs are being made. Too few and it reduces the chance of there being a viable decent egg but this is still better than too many... too many and you get over stimulated and will have to stop treatment until your body calms down. So you want somewhere between 4 and 18 follicles... as not every follicle gives an egg. When they have grown to the right size and there are enough of them you'll have the egg collection. You'll need to do a trigger injection top tell your body to release the eggs in 42ish hours (the egg collection is well timed at 36hrs after trigger).

Egg collection... this is where you're sedated but still awake and have your eggs removed from the follicles. This is an internal procedure where the doc takes a probe (like he'll use in your scans) but it has a very fine needle on that goes through your cervix and into each ovary and drains your follicles. The liquid goes into a tube and gets sorted through to find the eggs by the embryologist. This can be an uncomfortable experience or sometimes a bit painful but we've all done it and it isn't as bad as it sounds and is necessary!!

ICSI vs IVF

On the same day as Egg collection your partner or sperm donor will produce their sample too. In normal ivf the eggs are put into seperate petri dishes and a sperm sample in each and they're left to fertilise themselves. In ICSI the embryologist takes each egg and strips back the outer wall to prep for icsi. This can mean some eggs are not viable as they have to be mature enough to go through this process.....We had over 30 follicles... (I was over stimulated) and 19 were collected as there were too many. Of these 16 were viable for ICSI.....Then each sperm is selected for their quality and injected individually into each egg and left in each petri dish.

Then the process is the same....

The 'fertilised' eggs (embryos) are left to fertilise over 3 to 5 days. They are incubated and the embryologist decides after 3 days if they're growing well and if any are not. Don't be disheartened if some are not. Of our 16 eggs 11 fertilised. Over the first 3 days some weren't developing properly (which is all part of natural selection) but there were still a few contenders so the embryologist let them go on to 5 days. If there are 1 or 2 by day 3 they may suggest transferring them to you on this day as they know which is strongest and ultimately they're better inside you. If they leave until day 5 the embryos are then called a blastocyst (this would happen inside you if they transferred on day 3).

Transfer....the transfer is fine. You lie down with legs in stirrups and get tipped back... very flattering and all sense of privacy out the window (you'll be used to this by now!). Then it's just like a smear but less uncomfortable. They put a speculum in... widen up and insert a tiny tube to release the chosen embryo (s) into your uterus.

Whether they transfer one or two is up to your doc and you. Our clinic wouldn't allow 2 on the 1st attempt and age plays a factor too. They're more likely to allow ladies over 35. Having 2 inserted doesn't always mean twice the chance. There is obvs chance of twins but there's more risks to mum and babies. It's something you'll need to talk to your doc about. We had 1 both times.

Then there's the 2 week wait (2ww).... take time off... relax and do relaxing things or meet friends. This is the longest time ever in the process so far (until later!) After this time you'll take a test (do not test early... you'll drive yourself potty!) It is recommended not to test before 13 days after your collection. If you've had a 3 day transfer this would be 10 days post 3 day transfer (10dp3dt). If it's a 5 day transfer it would be 8dp5dt. Your clinic may also want to do a blood test (beta) to see whether you're pregnant. I tested 8dp3dt and got a BFP (big fat positive) and then 4 days later had a positive beta. The 1st cycle I tested I had a BFN which is really hard when you've been through all that... so be prepared for lots of ups and downs.

Best advice... take each step as it comes, don't fixate on dates (they change all the time), be prepared for delays and talk to each other about it but also have IVF free days!!

There's some good books out there... read it starts with the egg by Rebecca fett and the guide to ivf by zita west. That will give you a lot of answers. Your clinic will also encourage you to ring them with any questions.

Start talking a good pre conception vitamin (zita west does one you can order online with a vitamin boost too)... your partner if he is sperm donor will need to take a vitamin too. Eat healthily and try to get your bmi below 30 if it isn't. Drink tonnes of water from now until forever... I also took folic acid from now... and throughout pregnancy I am. And a DHA tablet (zita west) for good omegas. I also did and do acupuncture especially around EC and ET. yogame, walking and swimming are great for throughput ivf as lower impact.

Check out the acronyms on my profile... they helped me when I first started. Don't give up hope.... stay positive!!! I can't believe it but I am now 14wks pregnant from 2nd cycle!

Hope this isn't too much info but I'm a planner and needed to know what was ahead when I started!

This forum is awesome... the girls are great.

Good luck!!! Xxx

[CH91 in reply to Kat9lives]

@kat9lives

Hello lovely,

First of all ✨ BIG CONGRATULATIONS✨ To you and your partner!! Big hugs and kisses XxXxX

Wow that is a fantastic reply you basically covered all of my questions I'm so grateful thank you for that!

The only thing I was wondering is from start of the procedure ( starting injections) to finally taking a test how long does this normally take? I'm so impatient! Lol

Oh yeh and also did you start taking injections the day you went to sign your consent forms??

When I read your posts and other girls on here they all seem very clued up on IVF v ICSI to be honest I've found it hard to take it all in and understand it, my brain just gets over loaded then I think think think and think about it all and I gets me really down all me and my partner want is to have a little baby of our own to nurture love and care for in the best way possible and it just seems like everybody around us has been given that special gift but us ( even my next door neighbour is pregnant) did you feel a bit like this when you first started your treatment?

I have PCOS and my partner has a low sperm count we both also have very stressful jobs and have our own business to contend with!

I would absolutely love to be pregnant before the end of this year! Me and my partner have had a terrible year due to family being ill it's really been hard, and then this just put the icing on the cake.

To top it off with I am a prude and a bit scared anxious embarrassed for all the internal stuff you go through but to be honest I will do anything anything anything to have a baby!

Can you be sedated for all the internal treatment??

Lots of love xXx

[Kat9lives in reply to CH91]

Awww thankyou lovely.

Pleased I can help. Other girls on here really helped me when I started. Your initial consultation will be a while before treatment starts. We had our 1st consultation with our clinic (after a year and a bit seeing a specialist at a different local hospital) in early December 2015. They went through the different methods etc and we asked lots of questions. I had a blood test done and they have me a pill (provera) to take to induce a "fake" period and a date was arranged for us to come back to take injections for after when the expected period would happen. I took metformin for PCOS since about may 2015 (advised by specialist). I think injections started in early Feb for 19 days... I went over as I didn't have enough follicles (but on short protocol this is usually 2 wks) then EC happened and ET 5 days later. Then 2wk wait for test which I think was mid to late march. So 1st cycle took approx 3.5- 4 months from 1st consultation to testing. We got bfn (-ve) so had to wait for drugs to leave system etc and another period. Started injections second time on 25th May (so about 2 months between cycles), EC 6 June, ET 5 days later... 2wk wait then tested at clinic on 23rd June. Got bfp. So second cycle was much quicker as they had more info on me and how I react to drugs etc.

Lots of books etc I've read have said to treat the 1st cycle as a dummy run and try not to put too much pressure on as the clinic is gathering info (much easier said than done). The subsequent cycles they have more info and can tweak and change things easier.

I was exactly the same with feeling overloaded. It can be very overwhelming so take your time and don't expect it all to sink in at once. Trust me though, you'll be a pro and be able to hold a seminar on it by the time you've been through your first cycle!!! Remember the clinic are there for you and you can always phone them up to ask questions... read books and ask us on here too. The clinic will explain everything at each step so try to just focus on what is next for now. 😊 it's an exciting and v emotional time but keep positive! And be there for each other... this brought us so much closer.

I absolutely have been down at times and it's totally normal. Its these times when you need your support network around you. I chose to only tell a few close friends and parents and my sis. But use them! Talk..rant... cry... you need to let it out. Try to talk to each other too... it's important you feel like a team going through it together. You can do this... keep the faith and focus on what is at the end! It's so unfair that others can just look at each other and get pregnant but that's the cruelness of mother nature! The girls on here all so deserve to be mums as we all want it so much and have tried so hard for it to happen... it will happen xx

I have PCOS too and hub low sperm but his improved with stopping his protein powder altogether and improving his diet. Might be worth a try? I was put on metformin (have you been given anything?) try acupuncture for yourself and a gentle walk as much as poss as that will help de-stress...and helps pcos too. I bet having a business of your own is really stressful, we both have stressful jobs and found it tough at times but IVF came first no matter what. We explained to our bosses that we had some hospital treatment and we'd need time out the office (and used our leave for it). It's noone else's business but yours and that set the boundaries... might be helpful if you have any employees to tell? Or remove as much stress as poss from the start... lower people's expectations etc?

I would really try not to put a time limit on things and take each step as it comes. Raker said than done... I'm like you... I'm a planner and wanted everything to fit in around work and timing with our lives etc but it doesn't work like that. Your experience may have some stops and starts and hurdles in the way but all along keep remembering that each step or phase is the clinics chance to learn more. Also remember you don't "use up" a cycle unless you've had your eggs collected... so if a cycle gets abandoned before this... it's for good reason and is giving you the best chance possible for starting the cycle again next time. That's if it is nhs or private I believe.

You can't be sedated for the internal treatment sorry lovely... but honestly it isn't as bad as you're imagining. You lie back on a bed with your bottom half undressed and a paper blanket covering yourself... your legs rest on a little stool and when the consultant comes in (accompanied with a nurse) he or she makes polite chat then puts a condom on the probe (speaking frankly it is like a thinner and longer dildo!) They put a blob of lubricant on the end and ask you to open your legs and gently insert it and it is pain free. They do it alllll the time and by the end of your treatment you'll have had that many internal scans (I think I must have had approx 8-10 per cycle not Inc ET or EC) you won't think anything of it. It's over in 3 or 4 mins. My hub came in with me and sat next to me (at tummy level) and held my hand. We just looked at each other and smiled. Plus then they'll show you the pics of your ovaries on the screen and how many follicles you have as you stimulate. And the most amazing internal scan comes after your BFP when you see your little baby all nestled in your uterus at about 7-8 wks!!! 😍 You won't be thinking about the scan then... It's truly amazing how advanced technology is today.

Try not to worry... I hope I've answered all your questions. If you have any more just message me privately, no problem. Sorry for the essay!

Good luck! Xxx 🍀🍀🍀🍀🍀🍀🍀🍀😊

[MommaBear16]

Hi CH91 - I think the other girls have covered everything but I just wanted to reiterate that it's not as bad as people think it is and it's very exciting when you start your treatment. Also, this site is amazing for any questions you might have and there's a nurse on here too called Diane Arnold so between everything we've got everything covered! Haha Good luck with everything x x x

[Kernishp]

My husband and I had short protocol ICSI IVF. Physically it was fine, make sure you and your partner keep communicating. ICSI is a funny one because it's probably the only treatment in the world where a woman has to undergo the treatment for an issue that her partner has- while he undergoes no treatment himself. I struggled with this at times, especially when my husband was off having nights out and I was stuck on the sofa injecting myself and drinking water. Counseling helped so consider it if your clinic offers you any. We now have twin girls who are 7 months old and while I lie in bed and type this, my husband is downstairs trying to get them both to go down for a nap- payback for some of his nights out 😝

[Kat9lives in reply to Kernishp]

Hehe! Payback! 😊 x

[leah30]

Hi , we had ICSI , long cycle which felt very long lots of meds. I have endometriosis, my husband has low motility However we were only advised the morning of my EC that tgey looked at the sample again and thought We would have a better chance of fertilising with ICSI . I had 8 eggs collected with ICSI 5 fertilised and 2 were good to go . So I'm glad we did it . Our first cycle failed We've recently had a successful frozen cycle . It's not as scary as you imagine , emotionally it's very draining . youve done the right thing joining a forum it really helps you realise your not on your own and there's so many of us going through the same xx