PP 10:30 here. Thank you PP, for posting about the study. Agreed that correlation is not causation, and it is still unclear to me (and perhaps to the authors of the study and the medical community also) whether the correlation is between the ICSI and the birth defect, or the underlying infertility and the birth defect.

Our RE has told us we need to use ICSI because of the male factor issues caused by chemo. ICSI is the practice's "norm" also, so I may be at the same practice as OP. I would like to talk to the RE about the study and see if she thinks it might be beneficial to attempt to fertilize half of the eggs we retrieve with ICSI and half without, as some on this thread have suggested.

I'd do half and half. I have twins which wer IVF/ICSI. Totally fine. Any minor (and I mean minor) issues they have are very similar to my older child who was conceived without IVF.

I am PP 8:09, and I can link to a study that shows a *correlation* between ICSI and birth defects. It came out rather recently. Here's a news story about it.

https://www.nytimes.com/2012/05/15/health/research/birth-defect-risk-higher-with-fertility-treatments-study-shows.html?_r=1

But correlation is not causation, and this study did not get into things like ADHD or sensory issues. The question still to answer is if ICSI is the culprit, or the underlying infertility causing the sperm problems?

I'm not letting ICSI off the hook and saying it's totally harmless. It's just that it's not really possible right now for folks to say "it's the ICSI, but the IVF was fine" or "it's the ICSI, and not the fact that I was infertile in the first place" or "it's the ICSI, and not the fact that my body was flooded with hormones as a part of the IVF cycle." We just don't know for sure; it needs further study.

But again, to the OP's question, she should not feel pressured into ICSI unless her doctor can offer a reason other than "this is what we always do." I am sure that they are trying to eliminate the possibility of eggs not fertilizing, but is that worth the cost and time in a 33 year old? That's for the patient to decide. (Though I wouldn't dismiss the effects of smoking on sperm. Smoking has systemic negative effects throughout the body)

I am with PP -- can anyone cite to a study that scientifically shows ICSI is a factor in birth defects and/or ADHD? Not to be argumentative, just genuinely would like to know.

My husband has MFI due to chemo, and we have been told that sperm that have undergone chemo have a higher chance of producing a child with ADHD...to me this doesn't seem related to the ICSI, but rather related to the underlying cause of the infertility that leads us to have to use ICSI.

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).

Not to be argumentative, but why tie the ADHD and sensory issues back to ICSI specifically? Maybe they were caused just by going through IVF, or the drugs you took during IVF, or whatever health concerns existed that caused the infertility in the first place, or environmental exposures in utero or after birth, or even just coincidence.

I'm using IVF too, so I'm in the same boat and not trying to be critical of that at all. But there's so many other factors that are a part of fertility treatment and just giving birth to a baby that I don't know if we can point the finger at ICSI every time a child has a health issue. Particularly ADHD, which is so common now regardless of a child's method of conception.

With that said, for the OP I'd say that maybe you shouldn't do it, not because of risks to the fetus but because it's just another thing to pay for. It sounds like you're already against it, so if you are okay with the small risk that you may have fewer/no eggs fertilize, skip it. It's your money and your eggs.

thanks PP, I am really happy to I hear that. I think really ur right and following ur doctors input is important.