# Your thoughts on clinic recommending ICSI



## DazeyJ (Dec 22, 2010)

Hi girls, I just was interested to get your thoughts..

Myself and my DP had treatment a few years ago that eventually resulted in our gorgeous little girl through IVF...both myself and my partner tried several unmedicated IUI's before the IVF none resulting in pregnancies...every time we had an IUI they reported that the sperm had good motility etc etc before the procedure...however when it came round to the IVF they suggested that we needed ICSI as the sample was sluggish...we were a bit freaked as knew nothing about it but of course decided to go with it as were worried it wouldn't be successful...I have just undergone an IVF cycle and again they recommended ICSI at the last minute after defrosting the sperm...my questions are:

- how would you know if the verbal information they give you about the samples are correct?
- our clinic said they prefer to use ICSI but it costs an extra 650, are we not vulnerable to being convinced to pay this unnecessarily 
- I know that the clinics are all well regulated in the UK, its one of the reasons we came here from Ireland. do you think there's any regulation that covers this?

Anyway was curious about your thoughts and well done if you managed to get to the end of this...its just something that has always been on my mind...it just seems wierd to me that with several IUI's with several different donors the motility was never an issue, maybe I don't understand the process too well but surely they need to be more mobile for IUI's than IVF?


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## lmb15 (Jun 12, 2009)

Hey Dazey, are you using a known donor or the clinic's own sperm? If it's the latter, then no, you shouldn't need icsi. Donor sperm should meet strict criteria and because of that, ivf alone should be good enough. I'd've been extremely peed off if we'd been told we needed icsi when we'd already paid a fortune for the sperm.
In answer to your question about regulating sperm at clinics, the hfea is supposed to keep an eye on it. One clinic was fined massive amounts of money a few years ago because they were found to be using poor quality sperm, and patients having to do icsi. Like you said, icsi adds hundreds of pound to the bill (£900 in some clinics). That's just plain wrong.

So, if it was me, I would demand to know why the sample was so rubbish (unless you're using a known donor). 

Anyway, rant over!! When's your otd? Best of luck.

Lisa x


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## lmb15 (Jun 12, 2009)

Oh, I'd also want written semen analysis both pre freezing and post thawing. X


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## ♥JJ1♥ (Feb 11, 2006)

some clinics in the USA and Europe do ICSI routinely but if you are using DS via a sperm bank/clinic it should be high quality and not need it.  My friend was told after her EC that they ICSI her eggs with their DS, so they agreed to pay half the cost as they had not asked her. It resulted in her son so she is not fussed now


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## DazeyJ (Dec 22, 2010)

Hi girls, thanks for replying...we ARE using donor sperm ...they told us last time that they almost always use ICSI and this time they said that it was as a result of the thaw that it needed it...I had no idea that donor sperm should be of a quality that shouldn't need ICSI...I don't really know what to do next, Imb15 is that a routine thing they can give us, the semen analysis? Should that be something we should ask for first? I haven't had my ET yet (it is on Monday) and we still have one bill to pay for a blast transfer so we could bring it up then....it seems wierd to be complaining about sperm that gave us our DD and potential new sibling!

Wierd, this has always been on my mind but never thought I'd get that info as a reply! Is it possible that it could degenerate after the thaw even if good quality initially? Sorry for all the questions and thanks for any replies...


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## Pinktink (Dec 17, 2008)

Hi there,

we had two cycles of IVF at one clinic both of which we were told that the sperm hadn't thawed well enough and needed ICSI - we went to another clinic and had normal IVF and they told us if the sperm straw they defrosted wasnt good enough they would just defrost another one... we had 100% fertilisation on this cycle and it resulted in our BFP.

The clinic when asked about this, they told me their embryologist is an ICSI specialist and believes that all cycles should be icsi with frozen sperm...


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## DazeyJ (Dec 22, 2010)

Thanks for your input Pinktink, did you move from first clinic because you were unhappy with them? Do you think there is any point in taking it up with them? To be honest was more thinking along the lines of contacting the HFEA as our treatment there is potentially ( ) done.


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## candygirl (Aug 1, 2006)

We used frozen sperm (at the Bridge clinic) and ICSI was never mentioned at any point.  I had 1 IUI and 2 IVF cycles and now have 2 children, and there was never a concern about the sperm not defrosting.  Offering ICSI routinely does seem a bit odd to me, to be honest.


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## Pinktink (Dec 17, 2008)

I'm not sure to be honest - they are pretty up front about their strong recommendation of ICSI so I guess it probably isn't against the hfea rules although you could always enquire.

We did leave the previous clinic because there were a few things we were unhappy with - a lot of it was to do with the sperm situation but we also had some concern about some of the nurses and we found out after two cycles that the lady administering the sedation who we were led to believe was an anaesthetist was actually a nurse and we didn't feel comfortable about that or the fact that they are one of the only clinics that dont use anaesthetists - when we questioned our consultant they said it was because of money   

There are a lot of success stories from them (hopefully you will be one of them) and some of the staff were lovely so I don't want to bash them but I would be curious to know if they print stats on the quality of the sperm they defrost for IVF compared to that of IUI...


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## lmb15 (Jun 12, 2009)

Dazey - you are paying a lot of money for the sperm, so you have a right to know that it's good quality. At both mine and Laura's egg collection days, the embryologist came and told us about the eggs and the sperm. They removed the crappy sperm straight away, so we were left with a sample with high motility/morphology etc. IVF is all that's therefore needed.
Clinics shouldn't routinely do icsi in my opinion. Firstly because it's an unnecessary cost with donor sperm but also (and to me more importantly)icsi increases the risk of genetic abnormalities:
risk of genetic abnormality in natural pregnancy =1%
                                          In ivf = 2%
                                          In icsi = 3%

Although the overall risk is still low but, by artificially selecting eggs (ivf) and then sperm on top (icsi), you're going against what nature would do (survival of the fittest and all that). So, by using icsi, you're increasing your risk of abnormalities by 1.5 times compared to ivf alone. To me, that's an unacceptable risk when you shouldn't even NEED icsi.


I would definitely ask for semen analysis pre freezing and post thawing. You're paying for the sperm so  they should show you it's quality (or lack of).

Good luck with ET and the dreaded 2ww.


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## DazeyJ (Dec 22, 2010)

God Pinktink, wonder if that anaesthetist thing had anything to do with me puking my guts up after EC!   I really thought she was one...to be honest I would have a completely different attitude to the whole thing if they had been upfront about the icsi thing from the beginning but with both of us they threw it at us at the last minute...my DP after EC and gave her an hour to make up her mind, we knew nothing about ICSI and researched quickly and were freaked by any risks we saw but felt we had to go with it or the treatment would fail...with me they made me decide while sedated   again we didn't really feel like we had a choice..

lmb15 - the risks you are talking about put the fear of god into us first time round and I don't think we would have chosen it if they hadn't suggested cycle would fail without it..thankfully so far DD is perfect and hopefully next one will be too please god...


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## lucky2010 (Jan 10, 2006)

just a quickie but I'm sure it's not legal to get consent whilst someone is under the effects of sedation.


good luck xx


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## DazeyJ (Dec 22, 2010)

God girls, was just thinking and have misrepresented the clinic in this respect...this time round we actually signed a consent form the day before saying we were prepared to have it done if needed...it was just the embryologist came in to talk to me about the decision while sedated....nothing illegal happened!


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## Caz (Jul 21, 2002)

Ladies please be mindful that FF is a public site; anyone can read without being a member here and we need to be mindful of our obligation to protecting you and ourselves from the legal consequences of what you may say. 

Please feel free to use our excellent Private Message system to share sensitive information. 

Caz


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## Candy76 (Feb 19, 2011)

We had a chat with an embryologist about ICSI yesterday. He was saying sometimes ICSI is necessary because the egg might be thick-skinned, rather than the sperm being of poor quality.
He recommended to do both, ICSI on the first IVF cycle, especially if there is no experience of the eggs fertilising with that sperm.
If there were enough eggs retrieved, he would leave half of them to fertilising themselves and do ICSI on the other half. To us this made sence. And we are surprised no-one else takes this approach.
We had first met that embryologist over 3 years ago in a different clinic and got a very good impression of him then, so we trust his judgement. And we have come across a few of them over the last years.


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