First IVF Low Fertilization--Rescue ICSI


#1

This is my first IVF cycle. They retrieved 31 eggs. The day after ER, they told me only 4 naturally fertilized and asked me whether I wanted to do ICSI. Mind you, this was definitely over 24 hours after the retrieval (retrieval at 11 AM, call about ICSI around 1-2 PM next day). I said of course. The embryologist didn’t say it was rescue ICSI and actually told me the fert. rate is 70%. Well, later in the day, they told me 2 more fertilized naturally, and that there were 21 eggs on which they were trying ICSI (now I know rescue ICSI). I received a call today, day 2, that only 7/21 successfully fertilized with rescue ICSI.

Now I am reading about how miserable pregnancy success rates are with rescue ICSI. I should say that my husband has really good sperm count and there was never any discussion of morphology. Even telling me a 70% fert. rate is wrong-rescue ICSI has a much lower fert. rate.

My questions are whether they should have split from the beginning half of my eggs to immediately do ICSI (not rescue ICSI), or is this normal, that a clinic sees what happens with the first IVF? Will they be able to detect morphology problems that they could not previously detect with just IUIS? I feel a bit cheated, like they should have done the ICSI quicker, I even read that ICSI at 6 hours is better than ICSI at 22 hours.


#2

[QUOTE=HopefulHailey]This is my first IVF cycle. They retrieved 31 eggs. The day after ER, they told me only 4 naturally fertilized and asked me whether I wanted to do ICSI. Mind you, this was definitely over 24 hours after the retrieval (retrieval at 11 AM, call about ICSI around 1-2 PM next day). I said of course. The embryologist didn’t say it was rescue ICSI and actually told me the fert. rate is 70%. Well, later in the day, they told me 2 more fertilized naturally, and that there were 21 eggs on which they were trying ICSI (now I know rescue ICSI). I received a call today, day 2, that only 7/21 successfully fertilized with rescue ICSI.

Now I am reading about how miserable pregnancy success rates are with rescue ICSI. I should say that my husband has really good sperm count and there was never any discussion of morphology. Even telling me a 70% fert. rate is wrong-rescue ICSI has a much lower fert. rate.

My questions are whether they should have split from the beginning half of my eggs to immediately do ICSI (not rescue ICSI), or is this normal, that a clinic sees what happens with the first IVF? Will they be able to detect morphology problems that they could not previously detect with just IUIS? I feel a bit cheated, like they should have done the ICSI quicker, I even read that ICSI at 6 hours is better than ICSI at 22 hours.[/QUOTE]

Yes, it probably would have been better to just do the ICSI in the first place. Hindsight is always clearer, of course. But many clinics do 50% ICSI or even 100% ICSI just to be sure to avoid these issues.


#3

This is supposed to be one of the best clinics in the country, in NYC. I’m seriously angry. What does this mean? I have to be honest, in our IVF training, nobody even gave us the option of doing half or all ICSI, it was presented simply as if they think you need ICSI, sign this release so that they may do it if they think it is necessary.


#4

When I did my first IVF cycle, my clinic did not do ICSI on all cycles, only if there was male factor involved. We do not have male factor, but I specifically requested ICSI be done just because we pay out of pocket and I wanted the best chance for all eggs to fertilize. My decision was based on just reading a lot on forums such as this.

That is frustrating to have so many retrieved and so little fertilize, but it happens. Hopefully you will get a BFP out of this cycle and can put this experience behind you. Good luck!


#5

morphology is a standard part of a Semn Analysis. So you should be able to see what DH’s was.
My clinic covers ICSI in the cost for everyone, but doesnt do it on everyone. It depends on your DH’s sperm. My clinic has a way of getting the best sperm. They put them in a test tube with some mixture I believe, and the ones that swim up to the top layer are said to be the best quality (something like that). And they use those to fertilize the eggs.

I dont have any experience with rescue ICSi but wish you all the luck on this cycle. The first cycle is a tiral and error to a point. Its good that you had IUIs cause they know how you respond to stims atleast.


#6

it’s not standard to do ICSI in all IVF cycles and is certainly not required.

If your husband’s sperm was fine on SA, there was no reason for the clinic to know that his sperm would not be able to fertilize your eggs.

my DH has slow sperm, so we planned on ICSI on our cycles. however, we also got charged extra for this.

sorry to hear about your cycle, but you still have embryos in the running. it just takes 1 good 1!


#7

I also had resuce ICSI performed on my first IVF cycle we have no known sperm problems. We had 17 eggs retrieved 8 contained no eggs and 4 were not mature( after incubating matured) and the rest just didn’t fertilize… So they did rescue icsi the morning after and 3 fertilized, then later in the day 2 more fertilized. Our issue is probably a timing problem and or egg issue.

ICSI is almost always an OOP expense and won’t be reccomended if there isn’t any sperm problems.

If you don’t know the results of your DHs SA other than ’ he has good sperm’ I would ask for details.

Chances of pregnancy with rescue icis are very low… We transfered all 3 embies and did not result in a pregnancy… The fact you had some embies fertilize naturally is very good!

Best of luck :pray: :pray: :babydust: :babydust: You just need one!


#8

[QUOTE=HopefulHailey]This is my first IVF cycle. They retrieved 31 eggs. The day after ER, they told me only 4 naturally fertilized and asked me whether I wanted to do ICSI. Mind you, this was definitely over 24 hours after the retrieval (retrieval at 11 AM, call about ICSI around 1-2 PM next day). I said of course. The embryologist didn’t say it was rescue ICSI and actually told me the fert. rate is 70%. Well, later in the day, they told me 2 more fertilized naturally, and that there were 21 eggs on which they were trying ICSI (now I know rescue ICSI). I received a call today, day 2, that only 7/21 successfully fertilized with rescue ICSI.

Now I am reading about how miserable pregnancy success rates are with rescue ICSI. I should say that my husband has really good sperm count and there was never any discussion of morphology. Even telling me a 70% fert. rate is wrong-rescue ICSI has a much lower fert. rate.

My questions are whether they should have split from the beginning half of my eggs to immediately do ICSI (not rescue ICSI), or is this normal, that a clinic sees what happens with the first IVF? Will they be able to detect morphology problems that they could not previously detect with just IUIS? I feel a bit cheated, like they should have done the ICSI quicker, I even read that ICSI at 6 hours is better than ICSI at 22 hours.[/QUOTE]

Hailey, I can’t help but to wonder whether you technically fall into the same statistical group as other couples that get rescue ICSI. I suspect most people that resort to rescue ICSI don’t have the same apparent good quality sperm and good quality eggs that you do as a couple. I actually just got done browsing a well cited document about rescue ICSI, “Rescue ICSI of unfertilized oocytes after IVF,” and it would seems that most women in the study had poor egg quantity and quality (after all, most women and men with good eggs and sperm wouldn’t need to resort to rescue ICSI as often). So in other words, its my suspicion that low success rate with rescue ICSI may be an artifact of circumstances that don’t actually apply to you. Just my take.

Good luck!


#9

I think they should have done ICSI. I have always had this done every cycle, but I am a poor responder. It was never even presented as an option not to do it (this was before they even realized I would be a poor responder).

I would not give up hope on this cycle. You had 4 fertilize naturally. It only takes 1. Plus, I agree with the other poster that you may not have the same problems as alot of those who have rescue ICSI done.


#10

Hopefulhailey- what clinic are you using in NYC? If you dont mind me asking. I am inN YC and my clinic automatically does icsi.


#11

So what constitutes “male factor” to the point of using ICSI?

Our clinic was going to do half and half, but we balked at the high cost and they agreed it isn’t really necessary. My husband had 10% morph but his other numbers were great…his count is always in the 100-300 million range. I know ICSI is good for morph…what criteria do your clinic look for to recommend this??


#12

Francesca- If your clinic suggested half and half… I’d go for it. We will be doing it next time irregardless of male problems or not. You just never know… the extra cost is worth it to me. Every clinic has its own requirements, ours recommended we didn’t need it… I wish I would have said just do it anyways, our outcome might have been different.


#13

Rescue ICSI Success

Just wanted to put a positive note out there: After none of our 5 eggs fertilized after ER, the day after they called and said they will try Rescue ICSI. The next day they called to say that 4 out of 5 fertilized and with a 3dt they put back 1 embryo and froze 3 which resulted in a pregnancy and delivery of our little boy who is now 13 months old.

Our clinic doesn’t do ICSI on a first IVF unless there is a known male issue. My DH’s analysis came out great and unexplained infertility on my end so without seeing that there was no fertilization they wouldn’t have done it automatically. Next IVF they will know to do it right away. We are trying with our frozen rescue icsi embies this month:cross:

Good luck to all you ladies, and never give up hope. It’s always worth a shot cause you just never know.