# DILEMMA ... ICSI or CLOMID???



## ANDI68 (Aug 17, 2007)

Hi Girls, I've posted this on another thread also, I need a broader feed back I think.  Please feel free to give me your thoughts on this.

DH and I have just had our first failed IVF cycle.  Initially our tx was supposed to be ICSI but was changed on EC day to IVF as his count/motility had doubled since a test a few months before and embryologist said we didn't need ICSI and would recommend IVF instead.  His count had gone from 0.5 mil when first referred over a year ago to 27 mil and 51% motility last month.  We changed our mind and we had a poor fertilization from it.  8 eggs were collected and only 1 fertilized normally, 1 fertilized abnormally with 3 nuclei, 1 didn't fertilize at all and the other 5 eggs were immature.  

We had our follow up last week and the main factor of our negative cycle were the immature eggs, cons recommended changing drug from Puregon to Menopur.  I also ovulated early and had about 16 follies in the last scan before EC (all around 20mm) but it seems the larger follies (26mm) had popped too early and I guess the smaller ones were too immature to fertilize, leaving me with not many to work with.  I know ICSI wouldn't have helped the immature eggs to fertilize but we would want this to optimize our next chance at success and hopefully eliminate the multiple sperm fertilizing the eggs.

So getting to the point ....... ICSI is what has been recommend for next cycle.  

Because of DH's count, which is now classed as normal we asked about our chances of trying to conceive naturally.  Cons said she would prescribe clomid if we wanted to give that a go and it would help me with ovulation (even though I believe I ovulate ok) She said they prescribe it sometimes for unexplained fertility.  

Our dilemma is ... we wanted to get straight back into treatment as I think a break from it would put me off doing it again and I explained to the cons that I didn't think we had the time to wait to 'give it a go' naturally as I'm 39 and feel we haven't got the time to wait a few months to see what happens.  Although we've done that before I know DH's count was so low then that's probably why we needed help.  I don't think she would have offered the clomid if I hadn't asked the question and because of our age situation she said why not try it if we decide to take a break from treatment because they know DH sperm can fertilize eggs.

I know the descision is down to us.  I feel so confused because I know we're only having ICS next because of the poor fertilization, the clomid was offered because I asked about the chances of conceiving naturally and nothing in between has been offered to us ... IVF or IUI, I think because of the fertilization probs.  It's so weird that both ends of the scale are an option and I have no idea what procedure will give us the best chance .... anyone got a crystal ball?  

My first thoughts were to go for ICSI and then fall back on the clomid if it didn't work now I'm wondering what if that is the case and went for clomid after a failure and DH's count goes down and then that wouldn't be an option.  We are due to start early Jan if Dec AF arrives on time otherwise it will be Feb.  I've thought today I could get 3 months of clomid in first and could start in 2 weeks time.  It's gonna take at least 6 weeks to go through the DR and stimms and that would take us up to mid Feb/March anyway.

Does anyone know the success stats for either ICSI or clomid?  If ICSI will give us the best chance then there's no question about doing it I just feel so under pressure from the 'age thing' that I can't see this clearly at the moment, probably because I don't know enough about the clomid.  I really want to improve on what went wrong last cycle and feel I need to give those changes a chance also.

Any words of wisdom? please  


Sorry about the waffle


----------



## Scouse (Aug 9, 2007)

Hi Andi
you know my story so I can't offer you too much but............
With our first private consultant when i asked for IUI he basically laughed at me!  I too have 'unexplianed fertility probs' and clomid hadn't worked - consult basically said at my age (i was 36 then ) and for the time ttc (about 56 years) he basically told me my only chance was IVF!!!!!!!!!!!!!!!!!!
So we went for it, as you said, for the best possible chance of getting pregnant!

But its such a guessing game - you could conceive when waiting for next tx -
Consult analogy- clomid is first rung of fertility ladder, IUI second and IVF/ICSI  is right at the top! After 2 failed IVF cycles we know we made the right choice!

Altho we are taking 6 months out (for emotional repair!) and of course we are hoping for a miraculous natural conception, we have our next cycle already planned!

I, like you, am waffling, but there aren't any answers just 'gut feelings' i think!
I hope you make the right decision and pray you will be successful whatever you decide!


----------



## ANDI68 (Aug 17, 2007)

Hi Scouse,

Thanks for your reply.  I think we'd kind of made our minds up already, it's just that throwing clomid into the equation has confused us.  As we've both said .... clomid is the other end of the scale to ICSI and I guess an option for when taking a break and not a substitute.

Of course we want the best chance possible whatever the financial cost, which isn't in the equation ... it's an age and time issue for us at the moment.

Another thing that has also made me unsure is that DH's count has gone up so much and I want to pin some hope on that working without any assistance but again time has to be given a chance and that is what we don't have in abundance.  We had more time before but not a great count  .......    ...... how funny things turn around, and I am grateful for that.

Here's hoping we both have our miracles


----------



## kara76 (Dec 14, 2004)

i would go for the icsi hun, try naturally while you wait but i can't see how clomid is gona help that much....if you could have it while you were waiting brill but i wouldn't go on it instead of

i felt i wasted so much time and would never do that again


----------



## beckb (Aug 3, 2007)

Hi Andi

I agree with Kara I tried clomid for 9 months and got no where just felt I was wasting time.  I hope your af arrives soon, you can then plan ahead and have dates to work towards.  Wishing you good luck for whatever you decide is the right treament for you.

Bec x


----------



## ANDI68 (Aug 17, 2007)

Thanks Bec and Kara .... your thoughts have been a great help.


I have another dilemma now ... my job!!!!

I feel I want to give it up and go temping.  I don't want the pressure of having to beg for time off again so soon and to take my hols in Jan and have nothing for the rest of the year is freaking me out.  I temped before between jobs and loved it but I had work and I know it's a risk that I won't get any.  I'm not entirely happy where I am and would love a fresh start but because I can't commit to an employer with what's ahead I feel temping is the only answer.  I can't afford to give up my income even though I only work 4 days a week, we need to have something coming in to help pay for things.  I really want the flexibility and less pressure during my next cycle .. is this the only answer??

Is my head up my butt or what!!!


----------



## ANDI68 (Aug 17, 2007)

Thanks Spooks,

What does non medicated tx entail and does it limit days off work?

Andi


----------



## kara76 (Dec 14, 2004)

how are you hunni?


----------



## ANDI68 (Aug 17, 2007)

I went today to see how viable temping would be as I'm desperate to have a new job and now I'm not in a position to start with a new employer because of my imminent time off etc.  Well, it looks like I'm stuck where I am at the moment because the temp agency generally places people on short term contracts then my time off would be a problem for them too .... arrghh!!!

Anyone got any job ideas for me?

Hi Kara, how are you?


----------



## kara76 (Dec 14, 2004)

you could be in line for maternity benefit soon so hang on in there girl....

im ok spoke with clinic today and will get deffo daates on day 3 when i go for blood test and probably have my drugs upped thanks to my fsh


----------



## ANDI68 (Aug 17, 2007)

I know Kara, I just wanted to face the next treatment with less stress about work etc.

How did you manage to get so many tx in last year?  I'll use all the annual holidays if I take the 16 days off after ET.  Boss is okay with me and tx at the moment but once I start putting in sick papers I know it'll be a different story.

You're having your FSH levels checked again?


----------



## kara76 (Dec 14, 2004)

all mine has been annual leave to as i know things would change with sick notes, i was able to carry 2 weeks over lol madness

yep back at clinic on day 3 for fsh, just hope af comes on time


----------

