ICSI worth it?

[Marmar68]

Hello all,

I have noticed on my IVF cycle that they plan to do ICSI in my first ever cycle, we are planning to do embryo banking due to my low AMH but I have fallen pregnant recently naturally but unfortunately resulted in early MC.

There is no male factor involved and my husband’s semen analysis and sperm fragmentation we’re all normal.

Why could they possibly recommend ICSI and how would we benefit from it if there is no male factor involved?

Thank you so much

[Kittykat198]

I can't comment on why your clinic have chosen icsi as I'm not a medical professional or your clinic but I can say that it is standard practice in some clinics abroad?

We had it for mild male factor and were also told it might help with fertilisation rates. if you are expecting lower numbers of eggs, maybe this is why?

We had to pay extra for icsi though so worth asking your clinic directly about this if you aren't happy?

[Marmar68 in reply to Kittykat198]

Thank you for sharing your experience I do not mind at all about paying extra for it if it’s going to result in better outcome, the only reason I asked because in the clinic information guide in ICSI section they mention that there are some risks involved with it including some genetic and developmental problems in th embryo and long term health issues for the children born that way etc which has concerned me.

I will definitely speak to the clinic about it.

[Endofitall in reply to Marmar68]

I agree with above that it is more standard in clinics in Europe and they often then don’t charge additional. However, Definitely do question it.

Many drs go for ICSI on basis that they don’t want to risk poor fertilisation if low number of eggs. However just for your info, I’ve got low AMH and poor response with low number of eggs retrieved at all my cycles (as low as 1 and generally 3-4). And with no male factor, we’ve had 100% fertilisation of mature eggs in every round.

When we spoke to a clinical andrologist who is an experienced embryologist also (we got some extra tests done for my DH just to be sure given our RIF issues) she agreed there was no point us doing ICSI and best to allow egg to choose, the less intervention the better if possible. Different if you’ve had first round and evidence of a fertilisation issue.

Best of luck xx

[Marmar68 in reply to Endofitall]

Thank you so much for sharing, my AFC in my previous scan showed 9 follicles and AMH of 0.6 so low AMH is the only reason I could think of ICSI but I definitely agree with what you are saying and what you have been advised because clearly there are some risks involved with ICSI and they mentioned it in their information guide such as increased risk of MC, genetic & developmental defects, genetic abnormalities and long term health conditions for children born this way!

[Endofitall in reply to Marmar68]

It does seem most likely that’s the reason.

I mean it’s all in context and still a small risk - so if there’s known issue with fertilisation or male factor then it’s a different issue isn’t it. But I think if you’ve never tried IVF before and have good sperm parameters it seems worth a go. Especially as ICSI isn’t guarantee of successful fertilisation anyway.

Just to add we’ve frozen a sample of my DHs best swimmers too so that if he gets a fever or anything that might impact during all this we’ve got a back up. Given the money we are spending. And the issues with me. About £300 a year for that peace of mind and reduced stress is 💯 worth it if you ask me.

[Kittykat198 in reply to Marmar68]

I was worried about the increased risks from icsi but please remember when they are talking about a statistically significant increase this is still only 0. Of a percent increase.

Also tests don't distinguish why this risk is increased. It might be that it is male factor infertility itself that causes the increase (for example, older men having babies too therefore needing icsi rather and this meaning the increased risk is actually due to age).

The majority of icsi babies are born healthy and with no issues.

(I work in a related field)

[Mumsy23]

I wished that they went straight to ICSI with my first round. What a waste of money that round was. 12 eggs retrieved and bu the end of it i only had the one that I fresh transfer. next 2 rounds were ICSI. 19 eggs ( double fresh transfer, 3 in freezer) 3rd retrieval 13 eggs (double tranfer,2 in the freezer) i am 42 with AHM of 12.

[Destiny30]

They suggested ICSI for us as well (healthy semen) i was told if normal IVF didn't get successful and then later we apply for ICSI we will need to pay seperately and it might not be covered by the insurance. Anyway we opted for the same.

[Rainbow2023]

We went through embryo batching last year aged 41 and were advised to go with ICSI due to my age factor. My husband also had slight fragmentation.

On the day of collection for the first round we got 4 eggs and the embryologist said the sperm quality was good so we opted not to go with ICSI and got 1 x day 3 embryo. On the second round again 4 eggs were collected and we did the same (no ICSI) and 1 x day 3 embryo. We opted to do a third round, with ICIS (and Zymot sperm selection) this time and we got 6 x day 3 embryos from 16 eggs.

In the end we had 3 x day 5 blastocysts - 1 from first round (non ICSI) and 2 from third round (ICSI). All 3 were normal post PGTA testing and we have a beautiful baby girl from the non ICSI embryo which of the best rated out of the 3.

For us ICSI helped with fertilisation somewhat but didn’t improve overall conversation to blastocyst stage. However it could have potentially saved us an additional IVF round had we opted to go with it earlier.

All the best x

[Twiglet2]

I didn’t know my first round of IVF that brought us our was actually ICSI until we went back to try for a sibling and they said they would do the same again. we were using. Donor sperm so was standard practice. Worth a wee chat with the embryologist I have always found them really helpful 🤗

[Spicycurry]

IMSI is better than icsi.