Should I use ICSI with a sperm donor?

[Football61]

Hi, me again. This is my first IVF cycle (and I’m doing it alone) - and I have a thousand questions swirling around my head. Thanks so much for all your help.

I’ve just received my treatment plan, and it includes ICSI. This wasn’t mentioned previously in my consultations. I thought that ICSI was generally used when there is a problem with the sperm; but I’m using a donor, so his sperm is of good quality.

The embryologist told me yesterday that the clinic uses ICSI by default (it’s an extra £1,350), but I can choose to have standard IVF if I wish. She said that the fertilisation rates for ICSI and IVF are broadly similar.

I asked her if ICSI would be useful because of my age (44) and the probable low quality of my eggs. She said there is a school of thought which suggests that ICSI is helpful in that regard - but no strong evidence.

I’d be hugely grateful for your thoughts. This is probably the only cycle that I’m going to do with my own eggs - shall I throw everything at it, and include ICSI just in case? Or shall I save the £1,350 given there is no real clinical need for it (and my clinic is already charging a bomb)?

Thanks so much ❤️

[Hidden]

Hi there,

I used ICSI with my first two cycles. Started with 7 eggs (4 mature) first cycle of which only one fertilised and it underwent abnormal cell division. It made it to blastocyst 4AB, had a fresh transfer and it was a BFN. The other 3 mature eggs all degenerated with ICSI. When I enquired about this with the embryologist they said eggs can degenerate with manipulation especially when they’re older.

2nd cycle 0 eggs from 15 follicles.

So none for ICSI.

This clinic insisted that because the sperm are frozen, motility is impacted and ICSI is a must.

2nd clinic MOT of donor sperm >20, they decided that based on parameters on thawing and knowing my previous history that standard conventional ivf was good. 6/7 eggs fertilised normally on 1st cycle, 8/8 on 2nd and 3/5 on third.

There could be other factors affecting it too such as stimulation protocols etc…

Speak to the embryologist at your clinic, they should be able to discuss further.

Good luck

[Football61 in reply to Hidden]

Thanks so much for telling me about your experience - that’s definitely food for thought. I spoke to the embryologist yesterday, and she basically said that the decision was mine - either IVF or ICSI would be fine. But I might try and have another conversation and ask if there is a risk re manipulating older eggs with ICSI. Thanks again x

[km307]

Fellow solo mum here, I did IVF with a sperm donor and my clinic never even suggested ICSI. I was 40 at the time, got 9 eggs, 7 were mature and all fertilised, I got 6 embryos. My understanding was ICSI is normally used with sperm issues, and can actually be detrimental if not needed as it is then down to the clinic to select the best sperm and they don’t always get it right…

Some clinics will let you go with IVF and then if there are any issues with the sperm when it’s thawed, they give you the option to add on ICSI at the time. Maybe that’s an option for you.

Good luck!!

[Football61 in reply to km307]

Thank you - that sounds like a sensible compromise. Will discuss with my clinic x

[HedgehogMad]

Hi lovely, an interesting question. My understanding is ICSI is recommended with severe male factor issues and if there have previously been low fertilisation in a previous cycle (suggesting the eggs are harder to penetrate normally for some reason). I think my clinic offer an IVF/ICSI split at lower cost where they inject half and let the other half fertilise normally. Might be worth asking your clinic if they offer this XXX

[Football61 in reply to HedgehogMad]

Thank you 🙏

[Twiglet2]

my clinic used it as standard for donor sperm as it’s frozen, I didn’t even know we had ICSI on our first round until we went back for a sibling and they said same again ICSI. They said it has better success rate for frozen sperm. We had 7/10 fertilise first round with 6 blasts. 6/6 fertilised second round with 3 blasts and then 4/6 fertilise the 3rd round with 1 blast so varied success but I’m sure my age and egg quality declining is playing a bigger part than the ICSI but interesting to read Ms Jolly experience when older eggs are manipulated so I will ask for some of my clinics thoughts on that but we are planning to use ICSI again with donor sperm this round xx

[Football61 in reply to Twiglet2]

Thanks so much for your advice. Good luck with your next round ❤️

[AracLl]

Hello. We've used donor sperm for all of our cycles. Originally on the NHS and then privately. The motility of the sperm,although described as excellent by the two sperm banks were poor on all occasions and we had to resort to ICSI.

[Football61 in reply to AracLl]

Hmmm, that’s interesting. The sperm bank that I’m planning on using doesn’t provide much information. I asked them for the motility numbers, etc - but they said they don’t give out that information “as it’s confusing for patients”. But they said that everyone they accept has an above average semen analysis. I need a donor from a specific religion, so I’m hugely restricted on my options. And to be fair, the sperm bank have been really helpful and kind to me…

[AracLl in reply to Football61]

The private clinic we were at gave us the option of IVF or ICSI or the option to try both should we encounter any difficulties. We always requested the latter. The embryologist will always let you know following the thawing of the sperm what your best options are. Sometimes the process of ICSi can damage an egg but it tends to be the best option if the sperm is a bit 'sleepy' following the thaw. I remember the first time we were contacted by the NHS embryologist at the time to say the sperm had lower than anticipated motility and we were so upset to think we'd gone through months of injections to,what we thought was falling at the final hurdle, but it just meant they selected the sperm with the best possible chances. On all cycles we had fertilised eggs as a result.We have a beautiful 3 month old following ICSI.

All the very best x

[HollyT7]

so we had Isci and all ours that survived resulted in bfps, but would they have if we didn’t have it, who knows! I would have paid for it if we didn’t have it included in our nhs cycle. Partner had sperm issues and my eggs take longer to mature (they didn’t know until collection). My figures are on my profile x

[Football61 in reply to HollyT7]

Thank you 🙏

[Sweatsour]

Hi there, I have a beautiful baby girl from ICSI so I would recommend it. Most of the couples I know go with ICSI. I am not sure how do they test donor sperm as most of the couple undergo pretty detailed screening. I guess depending on the number of matured eggs you get on collection date you can decide to go half/half or full on with ICSI. My understanding is thar for ICSI that select the best possible sperm...I guess it all depends on the embryologist as well. Best of luck! Sending you lots of baby dust:)😀

[Football61 in reply to Sweatsour]

Thanks so much ❤️❤️

[Positive20]

Hi….this is a difficult call to make and I honestly don’t know too much about it. Our clinic just did it as standard even though there was no egg or sperm issue. Xx

[Football61 in reply to Positive20]

Thank you. I was already shocked at the original costs of the cycle - so when they added on another £1,350 for ICSI, it freaked me out a bit. I would go ahead with it if I knew that it was clinically necessary or would improve my chances - but my clinic seems to be saying that’s not the case. Aaargh, this is all very difficult! 🙈

[Eggfreezer2015]

I had an appointment with my consultant today and went to query this, he said that with anyone using frozen eggs (which I am) you can only do ICSI. I thought I’d add this to thread in case it’s also helpful for others who may read this post.

[TeddyBear5]

I have had ICSI with both my cycles with donor sperm. I think it’s standard at my clinic for donor sperm. Thought I’d share the results.

Age 35 - 8 eggs, 6 fertilised, 2 made it to blast.

Age 42 - 8 eggs, all fertilised, 2 made it to blast.

Xxx

[Football61 in reply to TeddyBear5]

Thanks so much. Did they give you a reason why they always use that procedure for donor sperm? x

[TeddyBear5 in reply to Football61]

no but I assumed it would be to ensure the best chance of fertilisation and / or MOT of the donor sperm?

[Twins2022]

I had a number of failed IVF rounds with donor sperm using my own eggs. To cut a long story short my very last go was to defrost my younger eggs and fertilise with a different donor sperm opting for ICSI. My consultant said to throw everything at my very last attempt. Out of 10 eggs that I had on ice, all defrosted fine and 3 survived the ICSI process making it to blastocysts. I was a fresh transfer and the other two embryos frozen. I now have a 5 year old daughter and 8 month old twins. I’m now 48! No regrets and I wish you lots of luck 🍀 x

[LuxFleur]

You might as well give it all you have and use ICSI. That way it is ensured that a strong sperm is selected by the specialist. We have always done ICSI for our cycles.