Sperm defragmentation testing and PICSI

[Here4ivfinfo]

I've had consultations privately and on the NHS over the last week after two failed transfers. We have male factor infertility. The private Dr brought up doing a sperm defragmentation test and moving forward with PICSI. The NHS Dr indicated that this was not necessary and that if we moved to private to only do PGTA testing on the embryos. She said that implantation probably only failed because they were chromasomally abnormal. I then had a quick google only to find that PICSI doesn't not improve your odds of conceiving or live birth. So I'm wondering aside from making more money, why do clinics offer sperm defragmentation testing? What's the point of finding out the reason if you cannot change the outcome? Or am I wrong and does anyone have information or experience with PICSI?

Thanks! xx

[JA-fnuk Partner Nurse Fertility Network UK]

Hope you get some replies to your post Meantime take a look at hfea.gov.uk -Treatments for more information about the test you mention So you can make a more informed decision about the best way forward

Thinking of you

Janet - Partner

[Here4ivfinfo in reply to JA-fnuk]

Thanks. It’s PIMSI that they would be considering doing, dependent on the result of the tests. This is due to us having 19 blastocysts on day 3 and 6 by day 5. I just spoke to an embryologist. The clinic said they don’t do much PIMSI. Only 17 people in 2022 with the outcomes similar to ICSI. I guess it’s hard to compare outcomes unless all the ICSI people had the same quality of sperm as the IMSI people.

[Mellia]

Hi just now reading your post and wanted to say that I had three PGT tested good quality blastocysts not implant when transferred, and my doctor explained they could be chromosomally normal and have good grades at 4BA but the quality of the embryos may not be good with high DNA fragmentation from sperm leading to the miscarriages I've had and negative pregnancy results after transfer. My doctor suggested my husband get a sperm fragmentation test some to check quality of sperm if we chose to move forward with another cycle. We had done the PICSI add on with our fresh egg donor cycle which was not helpful. Supposedly this test allows the embryologist to choose mature , healthy sperm with less DNA fragmentation by putting sperm sample on a dish with hyaluronic acid and the idea is that the healthy sperm will bind to the hyloranuc acid so only healthy sperm is selected for Icsi. We had 27 eggs fertilized and only two made it to blastocyst. We were initially told it was sperm quality, but then were told that despite choosing a proven donor she had poor quality eggs that were already arresting by day 3. So sperm fragmentation test may be useful for you but research does not demonstrate that picsi is superior to icsi. Good luck to you!

[Here4ivfinfo in reply to Mellia]

Thank you so much for taking the time to share this information. We’ve managed to conceive now via ICSI but I’m only 5 weeks 2 days so it’s still too early to feel confident about any of it. I will bare this in mind if we need to do further rounds xx

[Mellia]

Congratulations! So great to hear would you mind sharing what was the embryo grade you had transferred?

[Here4ivfinfo in reply to Mellia]

I think the clinic I go to grades them differently to other clinics so you might not be able to compare. I had two transferred, one was a 6B+B- and the other was a 6B-B-. The 6 stands for how old it is (day 6 blastocyst). I didn't really expect either to stick but here we are hoping they are normal and healthy and developing well 🙏

[Mellia]

Oh wow. That's amazing! So now you have two what a gift! We also have issues with male factor and I'm in my forties so not feeling too optimistic but reading stories like yours gives me hope.

[Here4ivfinfo in reply to Mellia]

We won’t know whether both or one of them stuck until we have our first scan. We were aiming for one but would see two as almost like destiny (not that I really believe in that!). I’m happy it gives you hope, I am the same. I love to hear about positive outcomes against the odds xxx