ICSI to IVF?

[B&C]

Hi all,

New user - my wife and I have just been through our first (sadly unsuccessful) course of fertility treatment. We have recently been to our follow-up appointment to talk about the findings and possible next steps, and I just wanted to get the views of the good people here on a couple of things that came out of it.

All throughout the course of treatment we understood that we were having IVF with ICSI - this was always the method of treatment described to us and indeed before the egg collection and transfer this is what we were billed for.

However at the follow-up session it transpired that we actually "just" had the IVF. This was not explained until we mentioned to the consultant that we were under the impression we had gone through ICSI, at which point the consultant said that sometimes the embryolist would change the method of treatment at this point depending on the situation (and the condition of the eggs and sperm), and that this was of course to give us the best chance of fertilisation.

We were shocked at this because:

a) we weren't told that this was even a possibility in the lead up to the treatment
b) we weren't told of this change of procedure at the time
c) we had subsequently been billed for assisted hatching which was part of the treatment, however the fact that we had paid for and not received ICSI was never mentioned

Whilst we are now aware of this, and the clinic did then hastily refund our money and give an explanation (however accurate) of the reasoning behind the change in treatment, I have serious reservations that this would ever have been picked up by the consultant had we not made her aware that we were expecting ICSI - indeed, had we not attended the follow-up session for whatever reason we would be none the wiser to this day.

Can anyone shed any light on this - is it standard protocol to amend method of fertilisation at this late stage, and what about the communication breakdown with the clinic - should we take this further? Has anyone else experienced this?

Any advice gratefully received as we just don't know what to think.

[jackoa21]

I can not give a lot of advice but I have never heard of this happening.. I have heard of doc's poss doing ICSI at the last min (like my doc) but they had me sign an appoval form first.
you may want to post this to the general board.. There is a lot more traffic over there..
best of luck

[Darby]

Hi B & C,

Sorry your first attempt with IVF was unsuccessful. My doctor explained to me and collected for ICSI at the time he collected for the IVF. He had indicated that the ICSI was a method of fertilizing the egg by injecting the sperm and was not the same procedure as assisted hatching. His office policy is to collect for IVF w/ICSI and refund the money if the ICSI (sperm injection) was not needed to fertilize the egg.

During my IVF I was constaintly pulling information from my doctor's office, it was not really freely offered. If I didn't ask, they didn't mention it. It was pretty frustrating for me. I would certainly inquire further if I were you.

Good Luck,

Darby

[Ghost]

ICSI is generally not needed unless there's a problem with the sperm (low motility). I can believe that they would plan for ICSI, get your signed consent for it, and then let the embryologist decide if it's really needed when he sees the actual sperm. Makes sense.

Billing you for it without actually doing it is a problem. People make mistakes, but that one sends up a red flags. If that's the only red flag about this clinic, I would not sweat it, since they made it right. But one or two more would have me shopping around.

[B&C]

Thanks all for comments so far.

Ghost - we were actually billed prior to the egg collection/ embryo tranfer, so I could understand that if we were told the ICSI wasn't needed at the time and were refunded straight away.

It's the comms here that actually gets me worried.

[Tracii]

Unfortunately I had found that with my clinic I really needed to stay on top of them 150% of the way..consistently asking and double-checking. I felt like a total pain in the butt. They have so many staff with different thinking and ways of doing things and so many patients.

I would check with your clinic and ask how/why the communication broke down...it is best to tell them your concerns and if they don't react well then I would look somewhere else. Afterall you are paying ALOT of money and have your heart set on a successful outcome. You need to feel you trust the clinic.

[samandaw1]

We will have to do ICSI due to some sperm issues. However, day of retrival, if the sperm look better (mobility, count, and the actual quality of them) they will prefer NOT to do ICSI. The ICSI process can ruin (about 20%) of the eggs. So maybe your sperm was good in all three catagories or maybe there were not enough eggs retrieved that they decided against ICSI.

None-the-less, your doctor should know these things and should have explained it the day after retrieval. My doctor has been fab. and explains everything as often as necessary. YOu may want to look around to find someone like that.

[JustinesBaby]

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