# ICSI causing poor embryo quality??? Possible? Advice please



## freefall (Dec 13, 2015)

I am such a weird case.....would be good to know if anyone else has any wisdom to offer about what is happening for me

So I have done 6 stim cycles so far.... Each time except for my first and last cycle I have had 'fragile eggs' that were intolerant of ICSI. But in the last cycle, when I finally decided to hedge and do half donor IVF and half partner ICSI none were fragile but the outcome was really weird and now I can't figure out if really it's eggs that have been the problem or actually it's been the sperm all along??

So my half half cycle they collected 9 eggs, we did conventional IVF with 5 of the eggs using donor sperm and did ICSI with the other 4 eggs using my partners sperm.

This time around 100% of my eggs fertilised and we're all still going by day 3.  But by day 5 the outcome was as folllows...

Of the 5 eggs produce 3 X 5BB embryos (good quality)
Of the 4 eggs fertilised with ICIS from partners sperm only produced 1 X 5CD (poor quality) embryo

So I am trying to figure out if it's my partners sperm that is the problem, or the ICSI procedure itself. I have to decide whether to keep trying with partners sperm or just do donor sperm seeing as I have had such an improved outcome with the donor IVF.  Obviously I'd prefer to have a child with my partners sperm and after being told for 12 months that it's poor egg quality that's the problem, now it seems they all think it's actually the sperm that is the problem. But is it possible it's actually the ICSI procedure that is the problem

Can anyone offer any words of wisdom...I am becoming a one person experiment


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## Beside_the_seaside (Oct 9, 2012)

I am sorry about your failed cycles. But, if there's to be a rewards for perseverance, I'm sure you'd be due one.

It does sound like the 'problem' is sperm rather than eggs. I don't have any direct experience of this issue (duff eggs here  ), but I've heard of a modified form of ICSI called Intracytoplasmic Morphological Sperm Injection (IMSI). In IMSI, sperm samples are examined under a much more powerful microscope to better assess their "morphology". It is said to enable the embryologist to identify tiny defects in the sperm head that would not otherwise be visible with standard ICSI. I know it is offered by the Lister clinic and probably others too. The Lister information sheet on IMSI is here:

http://ivf.org.uk/images/downloads/Lister-Fertility-Clinic-IMSI.pdf

I would also consider contacting Serum in Athens, Greece. Maybe just email them the content of your post, pretty much, in the first instance. I'm sure I've read somewhere of them being able to overcome fragmented/poor morphology sperm issues, can't think where I might have read it for the moment, but perhaps it's worth a try?

This post contains an unconfirmed link/information and readers are reminded that FertilityFriends.co.uk or its owners are not responsible for the content of external internet sites


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## freefall (Dec 13, 2015)

Thanks for you reply B_T_S.  I will ask my clinic if they have been using IMSI for my previous cycles as I'm not sure.

I'm trying to figure out if I should try 1/2 ICSI 1/2 IVF with my donor sperm in order to finally figure out if it really is the sperm or the ICSI procedure that is giving me so much grief.  At this point it does seem to be the sperm, but I guess I'd like the peace of mind of knowing 100% for sure that it is before I finally concede to having a child with donor sperm after never in a million years having thought that I would be necessary.

Plus as you can only use PGS with embryos created with ICSI if I want to do PGS with my donor embryos I basically have to use ICSI. In which case if ICSI is the problem and not the sperm then I'd be better off going back to my partners sperm! Oh it's a circular nightmare!  

The other thing that is driving me insane is that if I don't use my donor created embryo's and they stay in the freezer I can't get more donor sperm because of the legislation in Australia you can only have maximum of 2 vials at a time and if you have anything frozen you can't get anymore!! And I had hoped to PGS all my donor embryos to avoid keeping or transferring ones that are not viable.  But the whole point of using the donor in the first place was to avoid ICSI and therefore I couldn't do PGS.  Now that why I'm thinking if I do another round of half half but this time all donor then at least I can figure out definitively if it's
- my partners sperm or
- ICSI 
That is the problem.  Hard to imagine that it is the ICSI given that it is used so routinely for other women!  Perhaps I'm still in denial and the only way I'm going to get out is to go all the way with turning myself into a 1 person experiment and face my fears!  

Any opinions from anyone who cares to give one would be appreciated at this stage!!


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