Will icsi even help? : So I had my... - Fertility Network UK

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Will icsi even help?

Joeysjourney profile image
21 Replies

So I had my review appointment from my first failed ivf cycle where they retrieved 13 eggs but only 2 fertilitised (transferred day 3, negative test) .

In a nutshell, the explanation is that our egg and sperm just dont seem to like each other, theres no other medical reason. He explained the egg chooses the sperm and that's what makes the embryo. That's why he prefers ivf cycles over icsi as it allows the egg to choose the sperm it wants.

The consultant said icsi was the logical next step but it still may not help as while there may be a higher rate of fertilisation, it is the embryologist that picks that particular sperm for that particular egg. Its not the eggs choice, as nature intended, and therefore the embryo may still fail to make it as the egg could reject the sperm. Therefore our fertilised eggs may still not make it to transfer and/or we could end up with low numbers to transfer and no frozens again.

I read tonight that the success rates for ivf and icsi are largely the same.

I dunno, I guess I just thought icsi might be the solution to our problem. It's a bit deflating as I was pinning my hopes on it a bit.

Anyone any opinions?

Let's end on some good news. I managed to bag a cancellation appointment for my next cycle so I'm being seen in December instead of almost February! Happy girl!

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Joeysjourney
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21 Replies
Pnw2020 profile image
Pnw2020

Hi. I would say try ICSI. This is often used in older ladies even if sperm is fine as I believe the outer shell is hardened and can make it more difficult for the sperm! ICSI will at least control that process and as you got a good amount of eggs collected that should put you in a good place. Good luck x

Joeysjourney profile image
Joeysjourney in reply to Pnw2020

Yes he did say hard shell may also have been the issue. I guess icsi just levels the playing field for the likes of us, and gives us a similar fertilised crop to those who aren't having low fertilitisation levels! It's all a science and there's always an obstacle!

I've read a few posts about your good news! Congratulations, I mean its incredible news. You were one of the first people to reach out to me when I posted here in despair. I'm over the moon for you xxx

Pnw2020 profile image
Pnw2020 in reply to Joeysjourney

Thank you! Keep positive but also be your own advocate. I have my fingers crossed for your next cycle x

Ivfgotadream profile image
Ivfgotadream

I would try 50/50 if you get decent egg numbers - do half ICSI and half normal and see what happens? Even with ICSI less than 30% of my eggs fertilised normally

Joeysjourney profile image
Joeysjourney in reply to Ivfgotadream

That's an interesting concept! Hadnt thought of that. This is why this forum rocks!

Newbies1 profile image
Newbies1

Hi I had total failed fertilisation on the first round 10 collected none fertilised which was put down to compatibility issues too. Second round we did icsi all 7 eggs fertilised and 5 made it to 5day blasts so it definitely helped in our case hopefully it will be the same for you. You are getting a good amount of eggs too so fingers crossed you will have a much better round this time take care xxx

Joeysjourney profile image
Joeysjourney in reply to Newbies1

That's reassuring. He did say it would improve my fertilised numbers which to me means I've a better chance to make it to blast. And obviously for you that was the case also. Sorry about your first round, I'm sure that was devastating. I know when I realised I'd only 2 embryos I was absolutely gutted as I didn't think I'd make it to transfer.

Barenina profile image
Barenina

Hi!

My partner has low quality sperm and count so we’ve always done ICSI.

Even still we’ve had always had terrible fertilization rates. It started with 30-40% and we were lucky to get a boy on our second ICSI attempt with an embryo transferred on day two which had only developed into a three-cell.

Trying for a sibling we’ve had worse and worse results. We’ve had 6 ICSI attempts with 0-20% fertilization rates and never got a blastocyst. We’ve always transferred on day two with various quality on the embryo.

The doctors in a Norway just shrugged and said maybe I had poor egg quality. (I have PCOS and high egg count)

Fortunately I ended up doing a lot of research online and we ended up paying 600$ for a sperm comet test to test for DNA fragmentation in the sperm. It turned out his sperm had really high DNA fragmentation which can lead to poor fertilization rates (in the worst cases) poor blastocyst development and also recurrent miscarriages. I sooooo wish we had tested this before but my previous clinic just laughed when I suggested the test.

After consulting with a clinic in Greece, my partner was put on high antioxidants (vitamin e 300, Vitamin C 1000, vitamin D 1600 and q10 gold x 3.

He was also told to have daily to every other day ejaculations and he had a two week antibiotic treatment. Some suggest 3 months low dose)

Next cycle we had a 50% fertilization rate and the one after 60% fertilization rate! We had three blasts on our last try, and our first frozen embryo. Pregnant twice this autumn, hoping this one will stick 🤞

So if ICSI does not give the desired affects, I would recommend taking the DNA sperm comet test! Or anyways he can start taking antioxidants and have frequent ejaculations just to make it as good as possible!

It takes 3 months for the sperm to improve by the way. So it could be something to try if this next cycle does not work. But who knows, maybe ICSI will do the trick for you, for many it does!💫💫👌

Don’t hesitate to ask any questions!

Love Nina

Abloured84 profile image
Abloured84 in reply to Barenina

Hi Nina . Reading your response is so reassuring: I have been in a similar position for 2 ICSI cycles . Low fertilisation rates and given very little answers to why. Currently I’m a TWW with two day 3 “struggling” embryos . I don’t have much hope and have tested today (day 8) and got a negative but the story of your little boy has told me not to give up yet 🤞🏼

Joeysjourney profile image
Joeysjourney in reply to Abloured84

Sorry you're having a hard time as well! It's so frustrating isn't it. We are failing at the first hurdle and it feels like a mountain to climb! I've my fingers and toes crossed for you for your otd xxx

Barenina profile image
Barenina in reply to Abloured84

Don’t give up hope, it can happen 💫And if it doesn’t happen this time, know there are a lot of things you can do!

I can add that it took so many years to find out about my partners DNA damage that my egg quality was not great in the end. After we finally got a 50% fertilization rate and I was over the moon (!)…. 7 out of 8 eggs stopped developing on day two!!! 😵‍💫 so we still only had one to transfer that didn’t stick.

Embryo development from day 1-3 is mainly up to the quality of the egg I read. So I felt we were back at scratch. But then I found out I had low testosterone and started taking DHEA supplements for 3 months. On the Next cycle with 60% fertilization rate, 6 out of 7 eggs was good/excellent quality on day 2 and three made it to blast.

I also apparently had issues with implantation due to high plasma cell count 🤦🏻‍♀️ I found out this after doing a biopsy and they gave me an antibiotic treatment. So gosh, there can be more than one thing that’s causing trouble 🤦🏻‍♀️ But I am glad I finally started to look for answers outside the clinic, as they are so behind here in Norway!

Hope you don’t have any other issues than the sperm and that you will get your baby soon! 💫

SR90 profile image
SR90 in reply to Barenina

Hi, just wanted to jump onto this and say ditto! My OH has really poor sperm, we never got listened to when it came to investigating his side other than ‘it’s poor’. We had 2 complete failed fertilisation on our first 2 icsi treatments. Our third, we used AOA and managed to get 3 fertilise! It felt like a miracle. Could have been coincidence but we did nothing else differently. From that all 3 made it to day 4, and then 1 made it to day 5. Although not the best quality but it was a miracle to have transfer.

Since then, we have paid to have private investigations and just from an initial ultrasound scan... they found my OH has quite severe varicoceles which by the way our GP shrugged off 6 months ago and wouldn’t even check!).

There isn’t much point to my essay, other than just to say, when you know something doesn’t seem right, you’re right to follow your gut, and well done to you for getting the answers you knew were there!

P.S I have looked into antioxidants, that was my next step until we found out about varicoceles. x

Barenina profile image
Barenina in reply to SR90

It’s so frustrating right? To get total fertilization failure after doing an IVF treatment is just crushing! and then the doctors just shrugging 🤷

Can they do anything about the varicoceles? Operate on them? What are your next steps?

We also went to an urologist who found just one minor varicoceles, so we have no idea why he has so high DNA damage. I suspect because he has really tight testicles, and they get to warm.

We also did a 50% AOA and 50% ICSI when we got a 50% fertilization rate. But we had actually better results with ICSI. This was after doing the antioxidants and daily ejaculations so think what he did just helped so much what we didn’t need AOA 🤷🏻‍♀️ Or just coincidence …

Hope you guys get your miracle baby soon!💫

Don’t give up, I am 39 and my partner 41 and our last ICSI was the best result we’ve ever had. (Since 7 years, so it’s not always about the age. It’s finding the issues and addressing them!)

SR90 profile image
SR90 in reply to Barenina

Although I had prepared for no eggs to be collected, I was very surprised when we were told we had none fertilise at all! I naively thought... 13 eggs collected... I’ll be pregnant soon! 🙄

So we only had his tests done this week so are waiting for results but during the scan and consultation they said he had quite bad varicoceles on both sides and one was actually reducing the size of a testicle, the consultant is going to write to our GP to high recommend surgery 🤞

DNA fragmentation is such a whirlwind! No obvious fixes makes it so hard!

AOA seems to be improving chances for a lot of people I’ve spoken to, but again just coincidence maybe? Even our consultant said it’s hard to know if that’s what made the difference in our third round.

I’m wondering if we should start antioxidants now anyway... get a head start.

I’m only 31 and he is 33 so I like to think time is on our side, however as you’ve said, age isn’t everything because we have struggled more than some older couples. Feels like pure chance half the time! X

Barenina profile image
Barenina in reply to SR90

Yeah DNA fragmentation is a real whirlwind!

In most Norwegian clinics, the answer is to do ICSI. But for us it was not sufficient. Or it was with our son, but that was a real miracle with that one 3 cell embryo!

If he can get a surgery, that sounds promising no? Again, in Norway they said they don’t operate after the age of 30 as there is no point. 🤷🏻‍♀️ Why? I go crazy here, the answer is always to do as little as possible and it got us nowhere. The Norwegian clinics don’t really recommend the antioxidants but there is a clinic in Greeze (serum) which is famous for their dna fragmentation treatment. If I were you guys, I would start taking the supplements sooner than later as it is so easy and affordable and it can make a huge difference!

I also read great things about AOA and thought it would be the answer to our prayers and was really disappointed it didn’t really make any difference. But then again, it was amazing that the daily ejaculations and antioxidants had made such a difference that maybe we didn’t need it. Again, my clinic said it could a be coincidence, but I really don’t think so after so many ICSI treatments before with only 0-20% fertilization rates and no blasts.

Anyways, I am getting carried away here since I believe in it so much 😂

Good night 😴

Joeysjourney profile image
Joeysjourney in reply to Barenina

Hi nina thanks for your thoughtful reply. So sorry to hear of your troubles also, you've really had a journey.

I did raise the issue of fna fragmentation with my consultant and he said it really was pointless as it won't change the outcome of the treatment plan I.e icsi. I tend to have a different opinion that we can actually change our preparation in the lead up to the icsi as you say. My hubby is on coq10, vit D, vit c and omega 3 as well as a prenatal mens vitamin. So I hope that covers all the bases?

I will tell him about the daily ejaculations, he'll be delighted with this loling. They get all the good bits don't they haha

Barenina profile image
Barenina in reply to Joeysjourney

Hi, no problem. After all my experience and finally finding some answers I am happy to pay it forward so someone else might not go through all this. But it seems like you are way ahead already! Good on you, he seems way covered! I would only add vitamin E - 300ie.

Are you taking any supplements?

I ended taking a lot as well in the end, also DHEA because we found out my testosterone was on the low side. Which apparently can happen to women who are slim with PCOS who are getting close to 40 🤪

Yeah your hubby should love the daily ejaculations!😂 my partner was complaining about this saying he didn’t have the energy, but there might be a good reason young men have excellent quality = daily ejaculations ;)

Also before going into the next ICSI, the clinics often recommend the man don’t have an ejaculation since 2-3 days. I think my partner had a 30 hour break before coming in to the clinic. Some suggest shorter, like 20 hours. But I am not sure about this. My partner has low sperm count so we were also scared he would have to little. The point is that the longer the sperm sits in there, the more damage.

Let us know how your next cycle turns out!! 🤞🤞💫

Joeysjourney profile image
Joeysjourney in reply to Barenina

I will thank you! I haven't taken dhea as I'm UK and it's not available over the counter here. I didn't really know if i should take it without my consultant telling me to? I'd be up for it though if it helps!

I'm taking all the same supplements he's taking plus extra folic acid and pregnacare prenatal tablets. There's so much information out there I got super overwhelmed so I just took the ones that seem to pop up most often

Barenina profile image
Barenina in reply to Joeysjourney

I also took the same supplements as my partner on our last ICSI attempt ☺️ + DHEA. Yes, I agree there is so much information out there and it took me a long time to wrap my head around everything 🤪

I see you are 40, but you have a good egg reserve? 13 eggs collected is good! You don’t have PCOS?

When we finally got good fertilization rates, we discovered my embryos didn’t develop. 7 out of 8 embryos had stopped developing on day two 😵 so we again only had one embryo to transfer. It was so frustrating and after doing some research I found out that embryo development from day 1-3 is up to egg quality and not sperm. So in addition to shitty sperm we found out I had shitty eggs 🤪 after all these years!!!

I asked my clinic if I could take DHEA even though I have a really high egg reserve and they said ok, no harm. And guess what, all my eggs developed on the last round and we got 3 blasts. So fixing the DNA fragmentation for my partner and my testosterone levels was key for us! 🌟

DHEA is mainly given to women with poor egg reserve, and they are usually low on testosterone. DHEA makes your body produce sufficient levels of testosterone for your eggs to thrive when going through the 3-4 months it takes for them to mature from the waiting pool or something. (It’s complicated 😂)

But most women 40 + usually have low testosterone and you could benefit from it. You can easily have your testosterone levels tested and see what they are. Mine had dropped from 1,7 to 0,7 in 5 years which was probably the cause of my poor egg quality. I think under 0,3 is the level they say is too low, but to have good quality eggs you usually need your levels to be more like 1-2.

This clinic in New York is all about DHEA and is where I got my info from:

centerforhumanreprod.com/co...

ivf-worldwide.com/ivf-world...

“Androgen supplementation in our opinion is essential in all women with low-T (and/or high SHBG), and in all women above age 40”.

Anyways, just throwing this info at you in case you were not overwhelmed already 😂

Take care and peace out ✌️

SR90 profile image
SR90

Hi,

Our first icsi cycle, We had total failed fertilisation and we were told it was just trial and error and it was just a bad batch of eggs.

The second cycle again total failed fertilisation, we were told the eggs were much better but the sperm was poor.

I don’t think there is an actual answer, each cycle just varies so much! I would personally try icsi because everyone has such different results. For low fertilisation, they could always try AOA (I’ve mentioned it in my above comment).

Are you unexplained infertility? X

Joeysjourney profile image
Joeysjourney in reply to SR90

Aw dear love you both. Its such a hard journey! My hubby doesnt have low sperm numbers but it doesn't rule out fragmentation issues I suppose! It's such a minefield isn't it

Definitely trying icsi this time and just hoping and praying that it gives us a better shot.

Yes I'm unexplained. So frustrating x

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