I just wanted to put my two cents out there. We were initially at Shady Grove for 7 years and they messed up big time with us and didn't realise my husband had an issue DNA fragmentation. We wasted valuable years and they kept pushing donor eggs on us. However the one time they did PICSI on us we were successfull in our pregnancy and lost the baby at 6 months due to PPROM. After that they discontinued and said they don't do PICSI anymore as it is not helpful according to their studies. We finally moved to CCRM Colorade under Dr. Schoolcraft he helped with the DNA fragmentation and we had 6 embryos and are pregnant now in the second trimester he said PICSI and one more technology helps with DNA fragmentation and some sperm issues.

Despite having good fertilization with ICSI in the past, we opted for PICSI on our most recent cycle due to our recurrent miscarriage history. PICSI is just another screening step to select the best sperm. While our RE suspected a quality issue, we got several normal embryos from the cycle. While the jury is still out on PICSI and it was an extra charge, I don’t regret adding it. It’s such a tiny bill compared to the cost of another cycle, and after many failures and miscarriages, I was willing to try just about anything that was different to feel like I was improving our chances of success. I think you just have to go with your gut on this one. Good luck!

We did ICSI for Cycle 1 and had disappointing fert rate. It improved a lot in cycles 2 and 3 with PICSI. This was at GE a and I wasn’t told of any side effects.

We had severe MF and I considered PICSI instead of just ICSI. All docs I talked to (4-5 total, including urologists) said PICSI wasn't helpful. It's been a while since I did the research so I don't have cites for you, but studies didn't seem to strongly support it's benefit either. With ICSI the normal looking sperm are selected. We found additional peace of mind/info by doing a DNA fragmentation test (DH did his testing up at Cornell - there are apparently different test for DNA frag, and Cornell had a preference over the one that Dr. Shin at SG uses), which was the only thing about DH's testing that was normal. We had fertilization rates on the low end of normal for rounds where my egg quality was bad. The protocol that gave the best # of blasts also had the best fertilization rate, which was on the high side of normal. We did DE and the fertilization rate for that round was very high.

Other than PICSI not being particularly helpful, I don't know of down sides to it.

To clarify the last post, the information provided above does not appear to be from the uk government, but from some site in the UK. I have no idea how true the information above is. I found a couple of the studies. However, I'm sure that the consents would mention birth defects if there were evidence of them.

In all the consent forms that I signed, the risk of ICSI is that the egg may be damaged by icsi or may not fertilize. However, in general, icsi has a much higher fertilization rate than conventional ivf. It also costs more.

I also found this online from the UK government. https://www.healthcentre.org.uk/fertility-treatment/icsi.html
What are the disadvantages of ICSI?
ICSI’s method of directly introducing sperm into an egg defeats the natural process of only a select few sperm making it to and fertilising an egg. This can be a disadvantage because this selection process is nature’s way of making sure that the best sperm with the best genetic material are the ones with the best chance at fertilising an egg. Removing that selection process can lead to an increase risk of developmental and health issues for ICSI children, as well as a higher risk of miscarriage because of the poorer genetic material involved.

That being said at present there is no strong research proving that any of the babies conceived by ICSI have developed impairments in their cognitive and motor skills, but there is an indication of a greater risk of physical abnormalities. An international investigation into ICSI babies found that 4.2% had a major disability, most of these around male genitals. That 4.2% is thrice the number of children with similar malformations who were conceived naturally. This study also showed that a higher percentage of ICSI and IVF children suffered from a significant illness during their childhood.

As ICSI has only been in use for less than two decades, some concerns are hard to dismiss at present. One of these is the worry that children conceived through ICSI are infertile or sub-fertile as a consequence of the procedure, but again because the technique hasn’t been in use for that long, there is no concrete evidence to back such a claim.

Research into the effects of ICSI is still on going, although it might be a while before concrete findings can establish or affirm any of the more severe concerns about the technique. If you have any worries yourself, then the best thing to do is talk to your doctor, whose experience in the field and matter will shed some light on the matter and help you decide whether or not you would like to pursue ICSI as a fertility treatment.

Anyone aware of any downsides to PICSI vs ICSI? Or medical resources discussing this?