Jump to content



Photo
- - - - -

Borderline morphology - ICSI or not?


  • Please log in to reply
5 replies to this topic

#1 hopingtobe3

hopingtobe3
  • Global 100+
  • 412 posts
  • Gender:Female
  • Dx:Unexplained
  • My Clinic:OFC

Posted 10 January 2011 - 11:45 AM

I've posted this in a few of the expert areas but the andrologist suggest I post here as well so hopefully you have some thoughts you can offer on our situation.

We're doing our first IVF cycle and I'm looking for an opinion on whether ICSI would be good for us.

DH's numbers are all pretty good except for the morphology which is only 6%. My numbers generally look good as well. I've had one slightly high FSH reading but all others have been normal and my AFC is good.

We're being told that ICSI is only warranted when morphology is 4% or lower but given that 'normal' is 14% and we're only at 6 I'm wondering if doing ICSI would help our odds.
Our RE said that ICSI for morphology above 4% won't improve our odds at all but this seems counterintuitive since we don't yet know whether we'll have a fertilization issue and with ICSI we're guaranteeing fertilization.

We know that ICSI carries it's own risks, and certainly isn't free, but are afraid of not doing it and loosing a cycle to lack of fertilization.
What would you advise in this situation?

TIA

Feb - Oct 2010 - 4 unmedicated IUI's, 2 medicated IUI's with clomid - all BFN

Sept 2010 - surgery for uterine polyp

2011 - successful IVF, welcomed baby boy

FET #1 April 2016-BFN


#2 wishuponastar

wishuponastar
  • Cyclebase
  • 398 posts
  • Gender:Female
  • Location:Northern Alberta, Canada
  • Interests:I love reading, scrapbooking, music, spending the day with my beautiful daughters.
  • Dx:Unexplained
  • My Clinic:RFP, Foothills Hospital, Calgary, AB

Posted 10 January 2011 - 03:24 PM

We had a higher morphology and weren't advised that ICSI was a requirement for us after ER, but our RE did tell us that 7% of couples with great eggs and great sperm have absolutely 0% fertilization (for our clinic), so the way we looked at it was - we've spent so much money so far, were we willing to risk having none fertilize to save $1500? So we paid for the ICSI and were really happy we did. In the end, it's your decision, and a rescue-ICSI would probably be an option for you if you needed it, but as far as we were concerned, we went for it. Good luck with whatever decision you make - hope this cycle is the answer to your prayers!
Lilypie First Birthday tickers Lilypie Fourth Birthday tickers Lilypie Kids Birthday tickers

#3 CatL

CatL
  • Cyclebase
  • 577 posts
  • Gender:Female
  • Location:Gatineau
  • Interests:Windsurfing, wakeboarding, skating, reading, cooking
  • Dx:Unexplained
  • My Clinic:OFC/MFC/Ovo

Posted 23 January 2011 - 09:45 PM

Hopingtobe3, I see that you just had your ER on Jan 20th and that you had 8 fertilized eggs. Did you end up going for the ICSI? I'm curious as we have just started our first IVF recently (with ET planned in about 1 month) and we have a similar situation. My numbers are really good and the only issue with DH is slightly low morphology (7%). We were also told that ICSI would not make a difference. I've read about rescue ICSI, but I wonder if it is common practice at the OFC...
<p>Me: 36 (homozygous MTHFR + heterozygous Factor V Leiden) DH: 40 (slightly low morphology (7%))
May 2006 Natural pg - 1st M/C at 11 wks
Aug 2006 Natural pg - 2nd M/C at 8 wks
Dec 2006 Natural pg - DD born Sept 2007!!!

TTC #2 since Feb. 2009
IUI #1 May 2010 - BFN
IUI #2 June 2010 - BFN
IUI #3 Sept 2010 - BFN
IUI #4 Oct 2010 - BFN

IVF #1 - Long Protocol
Puregon 225iu, ER Feb. 23rd (8 total, 5 fert)
ET Feb. 26th (2x8cell grade 3), no frosties :-(
1st Beta Mar. 11th - 243!!!!
2nd Beta Mar. 14th - 667 :-)
1st u/s Mar. 28th - singleton measuring 6w5d and HB 118...Yippi!
2nd u/s Apr. 12th - no HB...3rd M/C at 9w2d :-(((

IVF #2 - Antagonist protocol
Day 3 u/s showed 14-15 follies
CD 3-6 2x2mg Estrogen daily, CD 6 start 100iu Puregon/75iu Repronex
ER - Aug. 31st, 2011 (12 eggs/10 mature, 9 fert)
ET - Sept. 4th, 2011 (sET grade 2 blast), no frosties :-(
Sept. 10 6dp5dt +HPT :-)))!
Sept. 15 beta = 9 :-(( Chemical Pg

IVF #3 - Estrogen Priming Antagonist Protocol - Dec. 2011
Estrace, 225 ui Gonal-F/75 ui Repronex
ER - Dec. 29th, 2011 (12 eggs/11 mature, 6 fert)
ET - Jan. 1st, 2012 (two 8 cells, grade 1), 2 frosties :-))
Jan. 8th 7dp3dt +HPT...Please let this be the one!!!
Jan. 13th 12dp3dt Beta 642, 15dp3dt Beta 3112
Feb. 3rd 7w1d u/s - Twins!! HBs 143 + 144
Mar. 9th NT scan (12w1d) - still 2 babies developing perfectly :-))

Our girls were born Sept.7th, 2012 (38 wks 1 day) weighing in at 6 lbs and 6 lbs 12 ounces!!<a href="http://lilypie.com/"><img src="http://lbdf.lilypie....com/z9eqm4.png" width="400" height="80" border="0" alt="Lilypie Pregnancy tickers" /></a>

#4 hopingtobe3

hopingtobe3
  • Global 100+
  • 412 posts
  • Gender:Female
  • Dx:Unexplained
  • My Clinic:OFC

Posted 26 January 2011 - 10:22 PM

CatL - No we didn't end up doing ICSI so were VERY happy to have 8 of the 10 mature eggs fertilize. And all 8 made it to day 5.
We talked to the docs more about the issue and decided that if we retrieved 4 of less eggs we'd do ICSI and that seemed like a good 'compromise' on the issue.
I asked about rescue ICSI and no, OFC doesn't do it.

Best of luck!

Feb - Oct 2010 - 4 unmedicated IUI's, 2 medicated IUI's with clomid - all BFN

Sept 2010 - surgery for uterine polyp

2011 - successful IVF, welcomed baby boy

FET #1 April 2016-BFN


#5 CatL

CatL
  • Cyclebase
  • 577 posts
  • Gender:Female
  • Location:Gatineau
  • Interests:Windsurfing, wakeboarding, skating, reading, cooking
  • Dx:Unexplained
  • My Clinic:OFC/MFC/Ovo

Posted 27 January 2011 - 08:59 PM

Thanks a lot for the information!! Wow! You must have been so encouraged that all 8 made it to Day 5 and that you have 5 frosties...I hope our cycle is as successful...Best of luck with your test on Feb. 7th!! I'll be sending you positive vibes ;-)!
<p>Me: 36 (homozygous MTHFR + heterozygous Factor V Leiden) DH: 40 (slightly low morphology (7%))
May 2006 Natural pg - 1st M/C at 11 wks
Aug 2006 Natural pg - 2nd M/C at 8 wks
Dec 2006 Natural pg - DD born Sept 2007!!!

TTC #2 since Feb. 2009
IUI #1 May 2010 - BFN
IUI #2 June 2010 - BFN
IUI #3 Sept 2010 - BFN
IUI #4 Oct 2010 - BFN

IVF #1 - Long Protocol
Puregon 225iu, ER Feb. 23rd (8 total, 5 fert)
ET Feb. 26th (2x8cell grade 3), no frosties :-(
1st Beta Mar. 11th - 243!!!!
2nd Beta Mar. 14th - 667 :-)
1st u/s Mar. 28th - singleton measuring 6w5d and HB 118...Yippi!
2nd u/s Apr. 12th - no HB...3rd M/C at 9w2d :-(((

IVF #2 - Antagonist protocol
Day 3 u/s showed 14-15 follies
CD 3-6 2x2mg Estrogen daily, CD 6 start 100iu Puregon/75iu Repronex
ER - Aug. 31st, 2011 (12 eggs/10 mature, 9 fert)
ET - Sept. 4th, 2011 (sET grade 2 blast), no frosties :-(
Sept. 10 6dp5dt +HPT :-)))!
Sept. 15 beta = 9 :-(( Chemical Pg

IVF #3 - Estrogen Priming Antagonist Protocol - Dec. 2011
Estrace, 225 ui Gonal-F/75 ui Repronex
ER - Dec. 29th, 2011 (12 eggs/11 mature, 6 fert)
ET - Jan. 1st, 2012 (two 8 cells, grade 1), 2 frosties :-))
Jan. 8th 7dp3dt +HPT...Please let this be the one!!!
Jan. 13th 12dp3dt Beta 642, 15dp3dt Beta 3112
Feb. 3rd 7w1d u/s - Twins!! HBs 143 + 144
Mar. 9th NT scan (12w1d) - still 2 babies developing perfectly :-))

Our girls were born Sept.7th, 2012 (38 wks 1 day) weighing in at 6 lbs and 6 lbs 12 ounces!!<a href="http://lilypie.com/"><img src="http://lbdf.lilypie....com/z9eqm4.png" width="400" height="80" border="0" alt="Lilypie Pregnancy tickers" /></a>

#6 anytime now

anytime now
  • Cyclebase
  • 2,561 posts
  • Gender:Female
  • Dx:Unexplained

Posted 28 January 2011 - 01:17 AM

Rescue ICSI is apparently not nearly as effective as doing it from the start, so apparently not a great solution according to my RE...
Me: 44 (sigh) DB is 40 (Dear boyfriend!)

TTC from March 2009-March 2011 before DB had arrived on the scene
About 9 IUIs, 3 IVFs total

2 pregnancies with 7 week miscarriage requiring D&C
2 chemical pregnancies


April 2011 began a relationship now with a wonderful guy with an 8 year old son.
Sept 2011 Natural BFP while trying not to conceive (how ironic)
First Beta Day 15 from LMP was 851, Beta 4, 19 days post ovulation 5382
7wk US showed a heartbeat of 150! 9 wk US HB 185

May 19 2012 DS is born!!