ICSI or IVF how do you decide? Help!!!

Hello everyone

I recently had my egg collection, with 10 eggs retrieved. There was some confusion about whether to proceed with ICSI or IVF after I questioned the initial recommendation for ICSI. It turned out that my consultant had misunderstood me from the beginning regarding the duration of our TTC.

Our main reason for undergoing treatment is to preserve fertility for the future, as I have a low AMH of 4.5 for my age. I have conceived naturally before after 3 months of trying, but unfortunately, that ended in a complicated miscarriage.

We don’t have any male factor issues—my husband’s semen analysis and DNA fragmentation results are all normal. After discussing with the embryology team and consultant, they leaned towards IVF, but they ultimately left the final decision to us.

I feel a bit nervous about choosing IVF, as it seems like ICSI might have a higher fertilization chance since it bypasses the natural interaction between sperm and egg. At the same time, I’m aware of the small risks associated with ICSI.

Is 10 eggs a low number to consider me as someone with diminished ovarian reserve and hence why opting for ICSI? I was told my AFC was higher than what I should expect to have with my low AMH.

I was wondering if anyone here has had a similar experience. What did you decide to go with in the end, and what are your thoughts on this?

[Greenleaves1]

10 eggs isn't low, my AMH was 5 and I got 4 eggs.

Personally I'd go for ICSI as it gives best chance of fertilization.

[Hidden in reply to Greenleaves1]

Thank you for your response, I had the same gut feeling but had some people saying if no issues better not to intervene and let it naturally happen it’s so confusing 🤦🏻‍♀️

[CyclingAddict]

I don't know what the right answer is but we had ICSI and now have a beautiful 12 week old son. We also have 6 PGT-A tested embryos in the freezer from our ICSI-IVF round. We got pretty good fertilisation rates.

Good luck in whatever you decide x

[Hidden in reply to CyclingAddict]

That’s great congratulations, do you mind me asking how many egg you had and how many fertilised to make it to 6 PGT tested embryos ? Was this just one cycle ?

[CyclingAddict in reply to Hidden]

I don't mind at all! It was all 1 cycle. I had 21 eggs collected and 19 of which were mature. If I remember correctly, 13 fertilised and 11 made it to blastocyst stage, where they were PGT-A tested. 7 out of those 11 were 'normal'. It's worth me mentioning that we couldn't conceive naturally due to my husband's sperm count (it was 10 million on the day of collection). I didn't have any obvious fertility issues and my ovarian reserve was high for my age. So we did IVF-ICSI due to male factor, but I believe ICSI can also give you higher fertilisation rates in general. Hope this helps! X

[Anisha29]

Some clinic do offer to do a mixture of ivf and ICSI. That way you can see what is more successful. Sometimes ICSI can be too harsh for the eggs.

[Twiglet2]

I didn’t even know I had ICSI until I went back to try for a sibling (they did it as standard for frozen sperm) I had 10 eggs that round with 7 fertilised and 6 embryos. As you said you have already had egg collection I’m assuming they have already proceeded with IVF and you will find out fertilisation rate now so I wouldn’t worry now your decision is done as there is no right or wrong answer. First round is sometimes a learning curve so one for you to think about in the future if you ever have to do another round but doesn’t sound like there was a strong reason for defo ICSI so no I don’t think you’ve made a ‘wrong’ decision as sometimes it’s a bit of trial and error. Good luck with everything xx

[HelzBelzUK]

My U.K. clinic used IVF first cycle. We then found out my husband had high DNA fragmentation so we switched to ICSI on their recommendations and used the zymot chamber. That was our worst ever cycle

We moved to Greece and the consultant uses ICSI as standard. We have had better results in Greece so i’m assuming their protocols have been better and also my husbands DNA fragmentation has really improved. I’d prob still go for ICSI if I was you and maybe ask for the zymot chamber as it does select the best sperm and you get a higher fertilisation rates x

[Wishinandahopin]

with 10 eggs from a woman under 38 and no male factor then ICSI is not needed. That said, some clinics are now doing ICSI as default as it doesn’t cause any harm but can avoid an unexpected low fertilisation rate.

I had ICSI but most of my friends who had IVF didn’t unless male factor was at play. We have all been successful.

I think IVF was the right decision for you with the information you had at the time. Fingers crossed it works- 10 eggs is great for having low AMH, I had very high AMH and got 15!

good luck!!

[Cornnuts]

Hi there, I’m 43 retrieved 10 eggs on 12/12/24 7 were fertilized via icsi but 0 made it to blastocyst. They said grainy eggs…?meaning quality was bad. They also think the icsi was too invasive for my old eggs. So in my case icsi didn’t serve us. We’re doing regular swish them around the same dish and let the strongest sperm in. We don’t have sperm issues so wishing for the best.

[Nevergu]

Our hospital reccomend ivf as my DH sperm results were good. Never had issues with fertilisation- out of 12 eggs we achieved 10 blasts and hes in his early 40's. ICSI is more invasive but helps if you have male factor. Some clinics just go with ICSIas standard now to improve their numbers , plus its additional revenue for them.

[ChocoMuffin]

Hey, ICSI is the standard technique in most clinics abroad. In Spain, for example, over 80% of IVFs use ICSI and it is not an additional expense for the patient. I’m still shocked how UK clinics charge extra for this! Using ICSI or not should be a medical decision based on the patient’s case but it is usually recommended for women with low ovarian reserve, male infertility and/or poor fertilisation after conventional IVF.

[Shantelbgh]

10 eggs ain’t low .. I got 7 and got 5 blasts with ICSI ..

[Hidden in reply to Shantelbgh]

Oh that’s great - were they all day 5?