32.5 yrs old - IVF - ICSI? To do or not to do?

[Anonymous]

We have no male factor issues, but I have two blocked tubes.
Apparently 90% of people at the clinic I'm working with chose ICSI, but the information I've read recently on this site it scaring me.
Would you automatically do ICSI b/c that is the 'norm'. I don't mind the extra cost at this point, BUT wanted to know if it really impacts success?

[Anonymous]

Why would you do it if there's no problem with the sperm? If your eggs look good and your partner's sperm are fine, then just let them do their thing and save your money.

[Anonymous]

What does your clinic say? Why do they do ICSI on 90% of the people? I'd wonder if it's 90% because of the kind of client they usually work with... in which case, their typical client has different issues than you... (I think- although it seems your eggs/natural hormones aren't the problem, which would be the same case with couples with sperm issues)

[Anonymous]

If your clinic is encouraging people without male factor problems to do ICSI, I would question the methods of that clinic. I assume they would do it to boost the number of fertilized eggs but unless they have reason to believe that the sperm won't do the work on their own, it seems like they're charging patients for unnecessary procedures.

[Anonymous]

If you don't mind the effort, and cost, of additional cycles try it without it. If you need to give every cycle your all, go with icsi.

[Anonymous]

I'd say it also depends on how many eggs you retrieve. If you only retrieve a small number like me (<5), you may not want to risk not having any of the eggs fertilize.

[Anonymous]

You may also decide that if you get a certain number of eggs you will do half with, half without.

[Anonymous]

Agree with the PP. Go half and half. I have a beautiful son conceived with ICSI and he has a birth defect. Nothing surgery can't fix, but I hate that he will have to go through that. I seriously do not think it had anything to do with ICSI but I will never know. (and I am in the very small minority regardless). Anyway, go 1/2 and 1/2 and use the non-ICSI if they fertilize. Then you will also know whether or not you need it in the future.

[Anonymous]

Why would you do ICSI if you don't have sperm issues? Why do you think your eggs won't fertilize without ICSI if you've never tried IVF before? Talk to your RE, but it's my understanding that there are some risks to ICSI.

[Anonymous]

I wouldn't. I have two children, both a result of ICSI, and both have mild issues. We don't have these issues in either of our families for as far back as we know so we think it was ICSI that caused it. My son has ADHD and sensory issues and my daughter seems to have the same (she's still young but am seeing signs of it already).

[Anonymous]

ICSI is definitely not "the norm." I question the judgment of any clinic that lets 90% of its patients choose ICSI. Why would you do ICSI if your husband's sperm is okay? My RE said to only use ICSI if you have sperm issues becuse there are risks to the egg.

[Anonymous]

I agree that you should see how many eggs are retrieved. I questioned using it (I'm 30 no issues, DH has male factor issues) and my RE said they could try without it but it would be a gamble to see how many fertilized. So, if you have a lot of eggs and are comfortable with gambling and possibly having to do another round, then don't do it. If you're paying out of pocket and can't afford another fresh cycle or just don't end up with a lot of eggs retrieved, I would do it. FWIW, we did ICSI on both our fresh cycles and are currently pregnant. My perinatologist said the only issues he has seen are rarely very minor cosmetic things that can easily be corrected.

[Anonymous]

OP Here:

What sort of cosmetic issues can result? What age are these apparent.

My clinic said justified ICSI b/c most of their couples have never had a natural pregnancy and so justify it that way suggesting that we don't know what success you'll have otherwise. B/c i have conceived naturally before my tubes were blocked, I feel like there's no reason this time would be different. I am against ICSI to be honest, but feel like it's being pitched as a major positive. My RE did suggest after my hesitation I do half/half and then if the non ICSI had success transfer those...but of course I'm paying for ICSI then.

Also my DH is a smoker so she feels like that's reason enough right there....but he was a smoker when I conceived DD#1 prior to having any fertility issues....

BUT his sperm are normal.

[Anonymous]

Anonymous wrote:You may also decide that if you get a certain number of eggs you will do half with, half without.

This is what I did. And of the half that we didn't do ICSI, zero fertilized. So I was pretty glad we did ICSI. As my RE said, the whole thing is kind of an expensive science experiment. You won't know you need ICSI until it's too late and none of the eggs have fertilized.

We didn't have a sperm issue either - unexplained fertility and slightly low morphology but my RE said not low enough that it should have prevented us from getting pregnant.

[Anonymous]

i had icsi with my first ivf, 2 eggs put back in, one boy.
i did not have icsi with my 2nd ivf, 2 eggs put back in, twin girls. everyone seems just fine. we went with the dr's opinion on what to do for each. good luck!