Help needed - ICSI vs normal IVF??

Hi all
Im wondering if anyone can help me please?
DH and I just went through our first IVF with ICSI and transfer at blastie stage. I have no reported fertility issues (had Lap and Hyst which was all clear) and DH has low sperm count/mobility. His count varies all the time anywhere from 8mil up to about 20million

We were told ICSI would be the best option because it bypasses all male factor infertility but it was unsuccessful for us.
I was a bit shocked that at our age and considering all this and with ICSI that it didnt work and we didnt get any embies to freeze either - our 5 that fertlised didnt develop well enough and didnt make it to blastie.

What I am wondering now is: Would it be best to try normal IVF - i.e. give DH's swimmers a chance at fertilising my eggs on their own in the hope of a better quality embryo in the end and perhaps some to freeze.

Does anyone know if it works like this? Has anyone had any experience with this and any advice etc would be greatly appreciated. Thanks

DH and I have used ICSI due to male factor also. His SA results have varied too, although I'm not sure to the same degree.

On our first cycle we were informed that on the day they would examine the semen to see if they could do IVF or would need to do ICSI. As it turns out we've needed ICSI each time. Perhaps you could discuss this with your FS/clinic?

Hi Loops,

We had success with ICSI and same as your situation there was no fertility issues found on the female side but DH had low sperm motility and morphology. We only had one successful fertilisation so our emby transfer occured with a 2 cell emby - we didn't even wait for blasocyst stage as there was only one to transfer back in any way and we were told that my uterus was the best place for our emby anyhoo. But that aside, my understanding is that ICSI would be a better option becase they can 'choose' the best, healthiest sperm to fertilise the eggs with in contrast to 'regular' IVF

Has your FS given any indication of why they think blasyocyst stage didn't occur - I guess it could be a range of reasons - even egg quality too, have they any ideas, or suggested an alternate plan for the next cycle?

Hope they can give you some answers - GL for the next round if you choose to try again :)

Loops, art can really throw a curveball at you and sadly you can understand why the term rollercoaster is used, sorry your first cycle didn't result in a bfp.

It seems to me that ICSI did work for you hun, you had 5 fertilise, which is pretty good. The DNA in the sperm kick in around day 3 of an embryo's development, to enhance your chance's of this occuring correctly, is your DH taking Menevit ?

Often IVF doesn't work on the first go, I know which FS you see and I personally believe you are in good hands,I see the same one :p ,

How did your post ivf appointment go ? What did he say he was going to tweak next cycle for you ?

Thank you, wonderful ladies for your advice, help and support.
Looks like ICSI is probably the best option then, maybe not to blastie this time???. Im still a little confused but I havent seen my FS since the IVF yet - I have an appointment on the 10th Sept. so I guess we'll see what he says then and where to go from here
WLAB - he is great, I do think Im in good hands, just the things and questions going through my head because I havent been able to see him as yet. I can't wait to see him and see what he says and why he thinks perhaps it didnt work.

Thanks ladies xoxo:D

PS I will let you all know how I go on the 10th. Im thinking it was the embryo quality and since the others didnt make it to blastie then perhaps the one they transferred was no good also (obviously since it didnt stick) but Im not sure why - arhh so many questions.:wall:

We will be trying again but not sure when that will be yet because we are quite broke at the moment.

Loops - that's the hardest part about IVF, you can transfer a perfect embryo and it doesn't stick, that is what happened to me last cycle, especially given my age, my blast was a grade, why didn't it take.

Just make sure hubbie takes the Menevit whilst you get financially ready, and track your cycle's in between, you never know ....

Your next cycle you will be outa pocket about $1000, so that is some fruit for thought

Thanks WLAB. So sorry yours didnt stick either. We'll get there eventually!
Hubby is on Menevit - so I'll keep making sure he takes that and Im trying to get some Royal Jelly at the moment too.
The money we get back from Medicare will help but still not sure if we will be able to afford it yet as we have lots of bills to pay and will probably need the $$ for that.
When you said out of pocket only $1,000 is that if it is going from scratch i.e. we dont have emby's frozen so would have to ge through full cycle again?

All the best to you for this cycle. Hope you get BFP!! That will then give me some hope too and hopefully we will be pg at the same time!

xoxo

Thanks for the Sticky Vibes Loops

$4666.25 (Full IVF cycle starting from scratch with Icsi)
$127.00 for the syneral
$4793.25 - Total - you will give to FS

$3834.60 - Medicare will give you back - 8 weeks later -
----------
$958.65 - outa pocket

No worries, anytime WLAB

Thanks for that breakdown - sorry Im a bit slow off the mark sometimes. All makes sense now though.
Its just the wait for the money back that is killing me! Arhh But it is good that we are only out of pocket that much in the end. I'd like to do another cycle this yr too just in case the safety net is still being dropped. Do you know any more about that?

Much love
me

Loops, I hope you get your answers from the FS. Waiting and not having answers to our questions.....the hardest thing about this whole experience!!

My hubby also has had hugely varying results with every test. From 8mill to 135mill! with morphology issues in some tests and motility in others. Due to that we went for ICSI both first and second IVF cycles, and as it seems that we'll be doing a 3rd stim cycle before the gov'ment shafts us all in 20210, we'll do ICSI again but instead of 2/3 day transfers we're gonna try for blasty transfer - I've noticed how many more people seem to have them on this forum.

My thoughts will be with you while you wait till the 10th....I've had what I've dubbed my 'second 2ww' watching my hCG levels rise sooo slowly over a week, progesterone as high as in a 3rd trimester and suffering from all the symptoms...but waiting till Thursday for my 6 week scan. I have all my questions for FS written down. The longer I'm doing this, the more in control I feel and the more determined I am. (except on days when the dog looking sad makes me cry!:rolleyes:) Take care, be strong

Hi Loops, just thought I would pop in and say 1 blastie from 5 fertilised eggs is a good result compared to what I would normally get. On average I was getting 15 - 19 mature eggs at pick up, about 13 - 15 that would fertilise normally, and about 3 that would get to blastie, so 1 blastie from 5 eggs, if that makes sense. Perhaps there is an option to look at increasing your stim dose to see if you get more follies and more eggs?? Wishing all the best for your coming cycle.

Loops has your DH had a SCSA to check the level of DNA fragmentation in his sperm?

This will give you a fertility rating for his sperm. You can have bad morph and mot, but low fragmentation that will give high fertility potential for ICSI. Conversely, good numbers, mot and shapes don't mean the sperm have good DNA fragmentation.

Good Luck!

Airline - Thanks so much for your help and support, yeh I hope maybe they will boost my dosages next time so perhaps I get more eggs. Lots of questions on Thursday.
Im a bit confused as to whether you think you might be pregnant or you are waiting until November. But whichever way - I hope you get a BFP very soon. FX for you!

Baby Dreamtime - thanks heaps for your help. I suppose they did say they probably wouldnt get many go to blastie stage but its the fact that it didnt stick I suppose is what puzzles me the most. Anyway at least I might have a few more answers Thus.

Amirylls - I did read up a bit about fragmentation tests and I think I was put off it, I can't remember why though. Proabably the fact that it is more money and we are really stuggling financially at the moment. But I will def look into it some more and will ask my FS on Thurs about it and see what he thinks. Thanks for the suggestion.

I don't think we will be doing another cycle in Oct like I had hoped because just when I thought we were uptodate with all our bills etc we get another one for over $3,000. If we could sell our tractor and other farm equipment we have for sale we'd be more than ok but in this financial crisis its really hard to sell them.

Thanks again ladies for all your help. xo
All the best to you xo

Loops our SCSA was done publicly through the andrology lab at the RHW in Sydney and cost less than $100.

Could that be an option? I don't know where you are, but the tests gave us a little hope. We have very bad motility and morphology, less than 2% normal, but our fragmentation came back as "very high fertility potential" and we managed to get five blasts in our last cycle.

OK edited to say I see where you are. Perhaps there are public labs in Melbourne that offer the same service. We were referred there by our specialist at IVFA who has a relationship with the Royal. Made things a lot cheaper for us in the diagnostic stages. Almost everything was bulk billed.

Amyrillys ~ that's not too bad, I must have been looking at American sites or something. Im in Gippsland Victoria but go through Monash IVF. Perhaps my FS will be able to tell me more.
Thanks for your help - i'll seriously look into that. It would be interesting to know.

Ta xo