# ICSI ignorance - please help



## sue93 (Jun 14, 2006)

hi there - 

does anyone know whether ICSI is ever used to increase the number of eggs that fertilise, or is it only used when they won't fertilise without help? Last IVF I had 3 fertilise out of 11 and wondered if they ever used ICSI to increase that number - I'm probably being very stupid here (or grasping at straws!) but wondering if that would be a way to increase the number of embies as thinking of going for PGS?

thanks in advance

Sue


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## three_stars (Jan 19, 2006)

Dear Sue,

I will try to answer and also add some questions maybe others can answer.

This is my personal take on ICSI.  I think that originally ICSI was used mostly when sperm was not so great.. maybe slow...or with older eggs as the outer "shell" tends to harden... and ICSI would be a help in these situations.  Now I see that some clinics use it pretty routinely to get more fertilised eggs.  Especially when they do egg share or there are not two many.  

My concern has always been that if they use ICSI and put one sperm that they have chosen  inside the egg, how do you know it is the good one?  Now that I am using donor egg and sperm, why wouldn't it be best to let nature take it's course in the petri dish, so to speak.  Maybe these extra fertilised eggs we get are in fact not meant to be and are the ones that often miscarry anyway later?  
I guess PGD would help to select the better ones... but I have been told that it does not always find the "bad or good" embryo and also can casue you to lose some of them.  More then just a littel confusing as to what is the best thing to do, isn't it?

I was reading last night from the ESHRE articles of the last yearly conference ( yes very dull I am indeed!!).  There was one study on 8 yr old ICSI children to compare with those not.  It seemed that in most all wasy they were pretty much the same... except there was ( IMO ) a pretty large difference in congenetal malformations, both major and minor.  I pointed out that in most cases these were able to be corrected by surgery.  I was rather alarmed by the %. ( sorry do not have them at my fonger tips but will try to look up again if any one interested.)  The writers of the study did not seem to be.. in generall the study did not seem to create concern for doing ICSI.


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## DippyGirl (Mar 10, 2005)

Hi Sue

I am so sorry to hear about your miscarriages. I think that B123 is right about ICSI being used to help get a higher fertilization rate with more mature eggs or endo sufferers both of which can have a harder outer shell. Assisted hatching (AH) is another method used to enhance chances of implantation in this case.

Regards choosing the right sperm, if you decide to use ICSI, you do put that choice down to the embryologist most of whom are incredibly experienced at all this. PGT is an option to help selection of course. If you getting as many as 11 ova per cycle (well done you) you could opt to have half ICSI half IVF and let nature decide which ones get to ET? Dr Sher has published a book called 'IVF - The ART of making babies' which covers this area and is worth a read if investigating options.

The reason for this post is to comment on the study of chromosomal abnormalities and ICSI. There are certain genetic conditions - e.g. cystic fibrosis - where the sufferer has an incomplete sperm duct so although they produce sperm they need ICSI to conceive. This gives people the opportunity to have their own children. This does mean that there is a risk of passing on the same genetic condition to offspring (for this reason I understand that these days PGT is recommended in cases of low or no sperm). Some studies on ICSI included cases of inherited genetic problems, when these are excluded the chances of abnormalities were found to be more or less the same. http://news.bbc.co.uk/1/hi/health/2077845.stm

Hope that this helps!
Best wishes
Dippy x

ps you could also check out this thread for options on repeated m/c http://www.fertilityfriends.co.uk/forum/index.php?board=52.0


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## sue93 (Jun 14, 2006)

thanks so much for the replies - got the info pack thru from ARGC today who say that they DO do ICSI for low fertilisation rates (which mine would definitely count as - 1 out of 3, and 3 out of 11 - had a cyst during the first cycle which I'm hoping explains the low response that time...) so that's another thing to consider. So many things...

thanks for all the info

Sue
x


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