Can someone please explain ICSI?

[Disney Baby]

And I don't mean the part how they inject a single sperm into the egg, I mean the procedure.

It's been recently found out that DH has high sperm DNA fragmentation, and we have been told by the clinic that his sperm sample on egg collection day will determine if we do ICSI or not.

My problem with that is that for the past almost 3 years we have been told he has excellent sperm, up until this recent test. They also said that they would do another DNA fragmentation test on the sample provided to see if the advice given has helped. My question now is that how will they know to do ICSI if his sperm looks good, but hasn't been tested for fragmentation yet? The last test took almost 2 weeks for results!

I don't even know if that makes any sense! I have the case of too many questions going through my mind that I am starting to jumble everything!

If you understood any of that, advice would be appreciated lol

[Disney Baby]

I guess nobody could understand what I was saying

Mods can you please delete this thread.

[SimpsonDesert]

Hi Disney Baby,

I am a little confused based on what you've written.

In our experience the DNA frag test cannot be done quickly enough to use the sperm the same day, nor does the test give any info about which individual sperm are best to select for ICSI.

DNA frag is done for information as to sperm quality and the options from there include:
1) High potency anti-oxidants and clean diet 3 months before next fresh cycle
2) 7 days of daily ejaculation leading up to next EPU. With ICSI, quantity doesn't count but quality does. This is to ensure high turnover of sperm in the epididymis, as its whilst the sperm is queued in the tubes that the DNA damage occurs.
3) Sperm selection techniques such as PICSI or digital high magnification
4) Surgical sperm retrieval (TESA/TESE) to get the sperm directly from the testes, thus obtaining sperm with no DNA damage.

My DH does #1 & #2 before our stim cycles & we always get high quality blasts with several frosties. We are on a long break from IVF at the moment, but if we cycle again, we will also do #3.

[Disney Baby]

Thanks SimpsonDesert!

That was what got me confused. I know that the test cannot be done quickly enough to be used on the day, but I didn't know what happened after that. All I was told was that ICSI will depend on his sample on the day, which I think will 'look' fine as it has done in the past, but it won't REALLY be good due to dna frag.

We have been told to do #1 and 2 this cycle to see if it makes any difference. I would have liked to try PICSI, but our clinic doesn't do it.

So basically, if we do the dna frag test again it means we can't do ICSI? Sorry, I'm just not understanding what happens to the eggs and sperm collected on the day if nothing is done with them?

My next cycle is all up in the air at the moment as it all depends on different test results which we don't have yet

[SimpsonDesert]

Conventional IVF requires a high number of sperm, so if they've recommended #2, expect a lower count in your DH's sample simply because the daily ejaculation will deplete the numbers. He may not have enough for IVF, but ICSI can go ahead regardless. I'd say that would be the main determining factor in the IVF vs ICSI decision.

As for testing DNA frag on the same sample, maybe your clinic will take what they need for IVF or ICSI and send the rest for testing? You won't get the result same day, but it may still give useful info. I don't know, I'm just guessing here... but that seems to fit with them telling you they'll retest the sample on the day of EPU.

Hope you'll get the full story from your clinic so you aren't left wondering. Good luck

[Disney Baby]

That actually makes sense now. I think I have just gotten confused because when we had our FS appt for the next cycle, we didn't have the frag results yet, so now things have changed. It's also not just our FS that we are dealing with this time as the Scientific Director has been helping us out a lot. He is the one that suggested the frequent ejaculation, except he said for 5 days but not the day before collection?

So no matter what his sample is like on the day, ICSI would be our best bet. I just hope they decide to do it on the day. I hate not knowing if they will or not!

[SimpsonDesert]

Oh good, glad it's making sense! Best do as your clinic advised with 5 days ejaculation then a rest day before EPU


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[peas sew]

not sure if you got your answer?? but we have always done cycles of isci even though my hubby sperm is of excellent quality as well. I dont respond too good to the hormones am put on, thus we do a isci cycle - in the past they said we had a higher chance of conception this way??
maybe need to ask your doctor?