IVF or ICSI?

[Avocado111]

Hi, one query that if male’s sperm has no problem/perfect, and I naturally fall pregnant before(but ectopic unfortunately), so choose IVF or ICSI? The price of the 2 are the same in my clinic, so it’s my decision to choose, which is better? and also wondering why my clinic charge same price? Anyone has similar experience? Thanks

[Rol81]

My understanding from my clinic is ….if male sperm is perfect then natural ivf is best . Though if you only get 2 eggs or a low number for example they might suggest isci as the numbers are low. They factor in a few things , age , egg quality etc. But my consultant is an advocate of IVF rather than ICSI.

[Avocado111 in reply to Rol81]

Hi, thank you for your reply, so low egg number, ICSI more secure, if enough eggs, then natural IVF, thanks, I’m 40, first cycle, will have my egg collection soon, estimated to get 4-5 eggs, low AMH, poor ovary reserve, because it’s my first IVF so even doctor is not sure how many eggs inside, probably I need to discuss with him before collection thanks for your advice, and do you know if there’s enough egg, why natural IVF is better than ICSI?

[Rol81 in reply to Avocado111]

I think it’s the quality of the egg too. I know others may have a different answer but this is what my consultant said to me :

If the quality isn’t great , ICSI is invasive and could damage the egg , also , they are selecting the sperm that looks good to the eye so to speak.

IVF is more natural, they just let all the sperm at the egg and the fastest best sperm is naturally selected without intervention.

I’ve always done ISCI , no sperm issues. Looking back, I should have tried ivf the first time. But because I don’t have many eggs and other factors (age ) we are now afraid not to do ISCI .

But my opinion is natural IVF instead of isci. Less invasive on your precious eggs. But then if it doesn’t work will you think ….what if I had done icsi 🫣

[Avocado111 in reply to Rol81]

Thank you for your explain, I have more clear picture now, will discuss with my doctor again

[Rol81 in reply to Avocado111]

I’m not great at explaining, but hopefully it’s helped . There’s two podcasts I listened to that had an episode on ISCI, I’ll message it to you .

But if I had a choice to go back, no sperm issues and good egg quality …I’d go for IVF. I think your clinic , esp as they don’t charge extra, will advise you what’s best .

ICSI is £1200 extra at my clinic 🙄

[Nabsal in reply to Avocado111]

Yes if eggs are less in number then go for icsi. Not normal ivf.

[Rol81]

Also the price…some clinics don’t charge extra because they don’t want people feeling one is better than the other . Like it’s an upgrade/add on. But rather a choice to consider depending on your situation …i.e maybe Sperm issue.

[Avocado111 in reply to Rol81]

My clinic offer package price( not cheap 😂), no matter what protocol you choose, no matter how many medications you use, no matter IVF or ICSI, including every scans and bloods, like me even one protocol doesn’t work, doctor stopped it immediately and changed to long protocol, no extra fees, no hiding fees, just one price, not cheap, but no hassle 😂

[Rella22]

I don't have experience with IVF as we have male factor infertility and automatically only option was ICSI. It's been a challenging road for us but we have had 1 successful birth and currently pregnant with our 2nd ICSI baby.Just ask your doctor the best recommendation and go with your intuition if price is the same.

[Nabsal in reply to Rella22]

You are very luck congratulations. Yes this journey is very difficult. I also had failed cycle now getting courage for next one. Mine is also male factor . Low morphology 😞

[Avocado111]

wow, congratulations on your success! You explained very clearly thanks, I think I will discuss with my doctor again, but I know all depends on the results of the egg collection and quality, just it’s my first time, have no idea which is suitable for me

[Football61]

Hi. Personally, if IVF and ICSI were the same price, I would definitely plump for ICSI - as it improves your chances for fertilisation. I’m 44 and used a donor who had excellent sperm quality - but I still used ICSI as I wanted to improve my chances (and throw everything at it). My two cycles using my own eggs were unfortunately unsuccessful. Although I’m still producing a large number of eggs, they are really poor quality - most likely due to my age. However, my fertilisation rates using ICSI were excellent - in spite of my eggs being poor quality. Wishing you the best of luck x

[Avocado111]

wow, another story, thanks for sharing your experience

[Fruitandflowers]

We were meant to do IVF as no sperm issues but there was a quality issue on the day (turns out clinic left the sample too long - don't even get me started...) so we were offered ICSI on the day. It was NHS funded so we just went with it. Had poor-ish fertilisation although two 'perfect' blasts, and we were told maybe the sperm quality issue had caused the fertilisation but they weren't sure. Next round sperm was fine again and we went with ICSI as we'd done it before (although was private so had to pay) - we got 5 eggs and all to blast, and I have a LG from that. So it certainly didn't do any harm for us. Would add we were advised that IVF is often recommended where there's a good number of eggs and sperm is OK as nature selects the strongest sperm, as opposed to an embryologist going off what they look like etc, we just went with ICSI on the second round as it had worked before and I was worried I had hard eggs or something as I'd never been pregnant naturally. But, I've somehow got pregnant naturally for the first time ever so am assuming that had we done IVF, that may have been ok too.

[Avocado111 in reply to Fruitandflowers]

Thank you for your reply, very happy ending🤓, I heard some people has hard eggs that have better chance to fall pregnant when getting older as eggs get softer than when you’re young, this situation def ICSI I think

[Fruitandflowers in reply to Avocado111]

That's interesting - never heard that before - quite like the idea my eggs have gotten softer with age (like my body in general!) Another thing we had suggested to us was that if we got enough eggs, we could do half IVF, half ICSI - we just went with ICSI as we'd done it before, and they all fertilised and went to blast, but now maybe in hindsight the half and half idea might have been an ideal solution. It's so hard to know though and every time can be completely different without explanation. I'm sorry you had ectopics btw, I must have been very scary for you - hopefully given your situation you'll get great results whether you do IVF or ICSI x

[Avocado111 in reply to Fruitandflowers]

wow, half half idea is great, yes every time can be different without explanation

The 2 ectopic drive me mad, both happened just in past 2 years, it’s dangerous I was sent to theatre straight from AE, tube removed, and this is my only 2 pregnancy history 😂, so even couples without fertility problem, the tube is another problem

[Avocado111 in reply to Avocado111]

Even I paid to check the tube before conceive, as I’m getting older, I want to check everything before conceive, they look all good, no problem, NHS do not check the tube for free if no good reason, so even went to private clinic to check, ectopic still happen

[Fruitandflowers in reply to Avocado111]

I'm sorry, I had a PUL earlier this year and they never got to the bottom of whether it was ectopic or not, but I was so scared because of how serious it can become so quickly, and the damage they can do, as you know so well. And I didn't feel the doctors were taking it seriously or acting fast enough. I can't imagine how scary it must have been happening twice. It sounds like you've been through a lot so hopefully the fertility treatment will work for you so you can have your happy ending. Ask about half and half and see what they say x

[Nabsal]

but I am confused if your husband has no issue either you then why you are doing ivf. You can get pregnant again naturally

[Avocado111 in reply to Nabsal]

2 ectopic, both tube gone

[Nabsal]

oh my god my dear extremely sorry to hear it. Do simple ivf. Not icsi. Because your husband is entirely normal. Or you getting treatment via nhs or private

[Nabsal]

because icsi is use for additional help which you really don’t need because you are okay as wel as your husband.

[Avocado111]

the doctor said if the rate ICSI 60%, then IVF 50%, and also depend on my egg quality I think, I’m 40, I don’t think the quality is good, and it’s my first IVF, no one knows the egg quality and quantity I can get though, so even doctor is not sure and ask me which one I prefer😂, but I did consult other clinic about it before I start IVF, all others recommend IVF, it save some money as well, but for my current clinic the price is the same, so if I got not enough eggs, ICSI may have a little more secure? Hard to decide

[Hidden]

We were in a similar predicament - husband had a history of male factor, so we always planned icsi - however on day of egg collection he produced a perfect sample so they switched us to ivf on the day and only 1 fertilised!! We were devastated, so second round we switched back to icsi even though his sperm sample was perfect again and we had zero eggs fertilise (out of 13!)!! Apparently there’s like a 3% chance of total fertilisation failure with icsi and it bloody happened to us!

We changed clinics and literally could not decide whether to do icsi or ivf as both were crap for us, so we went for icsi again and had 11 eggs fertilise!! Again, husband sperm was ‘perfect’. Honestly it’s all trial and error and every cycle is different, but we’d always do icsi over ivf from now on. It also cost us £1200.

Good luck xxx

[Avocado111]

I’m really sorry to hear this devastating experience, but very good result at last, yes it’s just need to try different ways, your first 2 cycles seems something was wrong with the lab? Good luck with your implant

[Twiglet2]

I didn’t even realise that we had ICSI on our first round that created 6 blasts (one being our little boy) until we went back to try for a sibling and they told us. I had thought it was IVF. We used ‘perfect’ donor sperm and I had no issues but they just gave it a helping hand as sperm had came from the freezer so it’s common with donor. I think it will depend on the day so if I were you I would be open to both and let the embryologist suggest if you dont have a strong preteen e either way. I have had 5 ICSI rounds and always had strong fertilisation rates is my experience xx

[Avocado111 in reply to Twiglet2]

Thanks for your reply, that’s what I’m trying to do now, talk with embryologist after egg collection

[Oopsieloopsy]

You don’t really choose in my experience, they will tell you what they think is best for your situation

[Bosta]

My husband had an issue with methodologies in two samples he gave so we went for ICSI.

On the day of my transfer they collected 10 and we were on our way home. Half way home we got a phone call from the clinic who called us back.

We were rushed back by the consulant who said we want to change from ICSI to IVF coz the sample my husband gave came out really good.

We signed the papers and changed.

They said IVF naturally is preferred as there is no invervention.

[happypupp]

If no male factor or no history of fertilisation issues, I'd go for conventional IVF, for it has a slightly less risk of birth defects.

[K8dferXdder]

as others said if no sperm issues-ivf is best. Icsi is the most aggressive method! Let nature do its job especially if you conceived naturally before I would go for ivf if i was you. Icsi doesn’t help if eggs are less in my opinion.