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TheExProphet

Any advantages to doing ICSI with healthy sperm?

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I'm working as a single intended parent (male) with a clinic in Texas, and we are in the process of beginning to create embryos. However I'm unsure about all of the extra "protocols" I'm being asked to do. For one, I'm being told that we will do ICSI despite the fact that my sperm is good quality?

I'm concerned as to why I need to do ICSI with good sperm quality, I'm also being told to do PGS, despite not having any medical issues. I don't know if this is meant to increase my chances of pregnancy or they're just added costs for no reason. The clinic reps tell me they will increase my chances of pregnancy but in my head I'm aware that's what they're suppose to tell me. I can't help to wonder if they just want more money, and all these extra protocols will be a waste of time/money.

Thoughts? Advice?

Edited by TheExProphet

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traci72    202

I'm doing this out of order, so forgive me.

PGS/PGD testing...this is a very personal issue, to me. I've never worked w/IP's that had tested embryos and it's never been an issue. None had known issues or concerns (though my 2nd IP's should have really considered this, but only based on their IVF history) and there was no reason to even think of testing. I could def. see this if there had been multiple IVF attempts w/out success or a history of chemicals or miscarriages, if the ED's medical history was limited or if there were specific things in your family medical history that could be tested for and ruled out. (my DS#1 has a genetic 'disorder' that predisposes him to specific early cancers and he has a 50/50 chance of passing it on to any child he has. This is something we can do PGD/PGS testing for and would be something that we are discussing as he gets older) If there are no red flags or reasons to do the testing, other than just to do it, if it were me, I would pass on this.

 

ICSI...this is different for me, and after my 1st surrogacy, I can see this. My 1st IP's were a same-sex couple. Both very healthy and no reason to think there would be sperm issues. The RE recommended doing 1/2 by natural fertilization and 1/2 by ICSI, simply because they didn't know if there could be a sperm issue, not having had a pg before as "proof". They reluctantly agreed. By day 3, the ICSI embryos were doing ok, a couple of "natural" embryos looked great, but by day 4, they had 2 embryos left, one of each. The slower one was the ICSI, the more "advanced" was the natural. By day 5 and time for transfer, the naturally fertilized embryo had almost completely stopped expanding and the ICSI embryo leaped ahead in growth. That was the one we ended up transferring, w/the intention of freezing the remaining natural embryo...it ended up arresting before it could be frozen. We don't know if had all been fertilized naturally, if we would have lost all of them, or if it wouldn't have made a difference and we still would have a good one to transfer and be successful. 

The next same-sex IP's I worked w/were offered the same thing, but chose not to do ICSI and just try the odds. We started w/twins the 1st transfer and lost one early on and I delivered a singleton. Next transfer w/them we had a BO and the transfer after that resulted in their twins. Same ED each time. ICSI was offered w/the 2nd surrogacy w/them and they decided against it again, but we ended up w/twins, so it was all ok. They had the mindset that if we had "a few" failed transfers, then they would turn to ICSI and potentially PGD/PGS testing. 

 

The explanation though that we were all given about ICSI, was that if there were known male factors, ICSI was a logical step to take and would significantly improve the odds. If there was not a known male factor, but there had never been a documented pg from that sperm, there was no way to know if there would/could be a male factor issue, and it didn't hurt to at least do 50/50, but that waiting to try a few transfers 1st was totally a reasonable thing to choose to do. My 1st IP's weren't sure how many times they would be able to attempt this, so they just decided to err on the side of caution. 

 

In the end, of course, it's what you feel is appropriate and feasible to do. If you are a healthy man w/no known issues, all testing/sperm analysis have looked normal, no family history of infertility, disorders, etc, I would probably skip on the the testing and at most, consider doing a 50/50 ICSI cycle, but would be willing to forgo all of that until there was a reason to really consider it. 

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@traci72: This was super informative and detailed. Definitely helped me clear the fog in my head. Must have been so difficult for your IP's to have lost so many embryos! I don't have any medical history or the like. However I have been irresponsible during my youth with my ex.girlfriend and she never came out pregnant! She does however now have a child with her new boyfriend, that itself makes me wonder and puzzles me. There are a lot of what if's because of it.

With the first same sex couple you worked with, did you guys achieve pregnancy from the ICSI embryo that was implanted?

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traci72    202

She turns 10yrs old this May!! 

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