I need a little input. For those of you that have been here, what can you tell me about ICSI? We aren't dealing with any male factor issues, but one of my doctors is recommending it (at least she wants me to go ahead and pay for it). I'd rather not do it at this point (I think I've signed up for about all the intervention I can stand already). Thoughts?
8 comments:
From my standpoint, ICSI was very necessary given our MF issues. So with that said, I was told numerous times that ICSI does not hurt the eggs. Can you ask about maybe doing half natural fertilization and half ICSI--I know some gals have done that.
But stick to your gut feeling--if your hubby's swimmers are up to the task, then you can probably avoid it altogether! Email me if you have any other questions.
I'm surprised that UCSF would recommend ICSI if you're not dealing with male factor. if you have no male factor ICSI is not necessary. the fertilization rates tend to be higher with ICSI than IVF alone, so if you only have a few eggs I can see why they might recommend ICSI. but you should ask.
in some cases fertilization is not possible without ICSI. some studies have shown a risk of harm to the egg, but in most cases there is NO harm whatsoever.
dr. c. recommended it for our IVF only because my hub had poor morphology. but we did "split ICSI" where they fertilized some eggs thru traditional IVF and some thru ICSI. we transferred 1 of each, but neither stuck, unfortunately.
~luna
Our ICSI was necessary due to MF infertility. I suggest you ask your doctor why she is recommending ICSI as there appear to be no problems with your husband. Is she concerned you won't have many eggs so she's trying to increase your chance of fertilized embryos? I think you're decision should be made based on the quality of her responses to your concerns.
We did ICSI for a couple reasons. My husbands counts were normal, but borderline (morphology was a little low). Also, we limited the number of eggs that we attempted to fertilize, so ICSI gave us a better chance at success with that. I was surprised when our RE recommended ICSI, but her reasonings made sense. 2 failed IVFs later, we've switched to a new RE. If we do IVF again, the new RE says that he would recommend ICSI in our case as well. Ask your doctor for the reasons behind the ICSI recommendation before you make any decisions.
Studies have shown that, whilst ICSI can improve fertilisation rates, it doesn't improve live birth rates. That is, some of the eggs/sperm that wouldn't have made embryos without ICSI, just shouldn't have made embryos full stop. Usually you want to achieve your goal - which is live birth, not fertilisation! - by the most direct route, so ICSI is not recommended unless you need it. (We did - no motility.)
Having said that, there are a VERY VERY small number of patients (especially seems to affect those in the "unexplained" category) where the problem or a problem turns out to be poor/lack of fertilisation, and you don't know until you do your first cycle. "Rescue" ICSI doesn't seem to have enough success, so sometimes doctors want to play safe vs sorry. Doing 50/50 might be a good compromise - if you can prove you don't need it you know that for the next time even though you won't need a next time! This is a very rare problem, so rare they mostly they just go ahead and treat you as normal til proven otherwise (ie no ICSI unless they see a specific need).
Bea
I agree with what Bea said, well put!
We did ICSI due to male factor issues.
We don't have any male factor issues. My husband had one SA on the low end of normal. My RE said that if he was doing IVF that he would ICSI all their eggs. We decided to go with that route. We almost got our cycle canceled due to poor egg response, they retrieved five mature eggs, ICSI'ed all of them and all five fertilized! And all five are still doing well today for our transfer. I would definately ICSI our eggs in the future...but that's just me. Anyways...I wish you much luck!
Hi there-
Came over from Lost & Found-
I had ISCI done both times due to my age and endometriosis.
Both my REs felt that rescue ISCI wasn't effective enough and both advised me that they had seen plenty of cases where seemingly fine eggs and sperm in the dish never created any embryos.
I agree with the comments above, maybe do a split, half ICSI, just to give yourselves the best chance possible.
Good luck!
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