Ghost or anyone... about ICSI

[chriss]

I was wondering about ICSI. I hear that the fertilization rates are usually 70-80 percent with ICSI. What could it mean if the fertilization rates are much lower using ICSI? Let's say 30-40 percent. Does this signify egg issues or could it be sperm issues as well? Thanks for all info.

[Ghost]

I was wondering about ICSI. I hear that the fertilization rates are usually 70-80 percent with ICSI. What could it mean if the fertilization rates are much lower using ICSI? Let's say 30-40 percent. Does this signify egg issues or could it be sperm issues as well? Thanks for all info.

Good question. As you know, ICSI is used to get the fertilization rates up, especially for male factor. If the rates remain low with ICSI, the problem could be the eggs or the sperm, or both. I don't see any way to know the problem just from the rate.

[cjpreasha]

We choose the ICSI process due to my husband only having 14% of his sperm normal shaped. Out of the 18 eggs that were taken...11 were mature...and 6 were fertilized and extremely healthy. I hope this sheds some light on your question.

[chriss]

Ghost,
Thanks for the response. Are there tests that can be done to tell more about sperm quality besides the usual sperm analysis? I've heard that there can be problems with sperm that are not detected by looking. We know thet my DH has low count, low everything...Seems like all we've ever been told is do ICSI, but how do we know that the sperm is up to the job? How does one know if donor sperm is needed? Is ICSI always enough?

[chelly180]

chriss-
for our 1st IVF cycle our clinic had us do ICSI just because DH has never fertilized or created a pregnancy. He has no sperm issues (he actually thinks he has super-sperm ) but the clinic wanted to ensure we had fertilization just in case. They did 1/2 the eggs ICSI and the other 1/2 regular and we had comparable numbers for both, about 80%. We transferred 2 3d embies, and they cultured the rest to blast for freezing. Unfortunately only 1 made it to freezing, but I don't think that means there is something wrong, I think they said only 10% of people have frosties anyway.
Hope this helps.
-Michele

[Ghost]

Ghost,
Thanks for the response. Are there tests that can be done to tell more about sperm quality besides the usual sperm analysis? I've heard that there can be problems with sperm that are not detected by looking. We know thet my DH has low count, low everything...Seems like all we've ever been told is do ICSI, but how do we know that the sperm is up to the job? How does one know if donor sperm is needed? Is ICSI always enough?

There are some genetic tests they can run.

Another option is to try donor sperm (or donor eggs) and see if it improves much.

[chriss]

ghost, do they do the genetic testing with the sperm or with the blood?

[RBJean]

Chriss:
We did an ICSI cycle in February and ended up with only 3 fertilized eggs out of 13 and ultimately a BFN. DH has severe male factor (very low everything). Our Dr recommended two additional tests: FSH or Aneuploidy test (tests if correct number of chromosomes are present in sperm) and DNA fragmentation. Either one of those problems can affect the ability of a sperm to fertilize and egg and/or create viable embyos.

Hope this helps.

[Ghost]

ghost, do they do the genetic testing with the sperm or with the blood?

I wish I knew more about it, but it's not something I have studied. Your doctor is the one to ask.

Keep in mind there is variation from one batch of eggs to the next, from the same patient. There may be no major problem, just one bad batch of eggs. We get some patients who repeat and their fertilization varies a lot. It may have something to do with the uniformity of the cohort of follicles. More uniform is better, and small follicles tend to produce poor eggs.