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  1. #1
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    Default Failed ICSI cycles

    Hi everyone,

    I'm new to this forum. Wanted to share my struggles and experiences with ICSI so far. We have severe male factor, my husband was born with undescended testicles which were repaired at a young age, so he has extremely low sperm parameters. I have been tested as normal. I have done all the blood works, had a hysteroscopy and looked at immune issues. I'm 27 years old and my husband 33. We have gone through 4 rounds of ICSI with no success!

    ICSI: 1. 13 eggs retrieved no fertilization
    ICSI: 2. 4 mature eggs, 2 fertilized: 2 day 3 grade A embryos transferred BFN
    ICSI: 3. 13 eggs retrieved, 10 fertilized, 6 made it to blastocyst stage. 1 fresh grade B blast transferred BFN. 3 of the blasts were suitable for freezing.
    FET1: 1 blast BFN
    FET2: 1 blast BFN

    Recently we decided to do a fresh cycle of ICSI in order to do PGD. however, in this cycle we only produced 4 eggs, 3 mature and NONE fertilized. (it was the same protocol as ICSI number 3.) we were devastated.

    We still have one last blast from cycle number 3. But really don't know if there's any point using it, considering none of the fresh or 2 frozen have ever worked for us

    Any feedback and guidance would be much appreciated.

  2. #2
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    Hi Hun we have MFI also and have used ICSI for our 2 stims. In fact the second one was PICSI. Our first go when I was 35 yielded 16 eggs all of which fertilised (from memory) and this time 3.5 years later we ended up with 9, 8 of which fertilised. My hub has count motility and morphology issues. Both times we've ended up with at least half that number ending up as blastos for freezing (this is a good sign because quite often they drop off after day 3 or 4 due to sperm quality).

    What does sound a bit worrying to me is at your age you are only getting 4 eggs on some cycles. This is really low and your protocol should be looked at to make sure you're being stunned correctly. And other female factors should be investigated.

    I would recommend PICSI too as sometimes the embryologist chooses sperm which looks good under the microscope but it may still not be normal. We ended up with one pregnancy (our daughter) and a recent chemical pregnancy. I feel more comfortable that we are giving ourselves the best chance with PICSI though as it's not all left up to the embryologist assessment of which sperm to use.

    Each persons situation is vastly different so it's not really possible to give advice directly just what we have experienced ourselves but in my view is be talking to your FS and asking more about why you have had a few cycles with so few eggs (particularly if it's the same protocol) and ask about PICSI. Also start on a vitamin regime to improve egg and sperm quality. Without seeing sperm results it's difficult to say too much more about what's happening but that should be a good start. Good luck Hun - IVF is damn hard work!

  3. #3
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    Thank you so much for your feedback.

    I've looked into PICSI. That is similiar to HA-ICSI, which is what my clinic offers. Except we couldn't do PICSI due to very very low numbers I think you need a few thousand sperm at retrieval to do PICSI.
    This last protocol I was on that produced 4 eggs, I only stimed for 6 days only! and the nurse said I was ready for collection. Had 14 follicles on one side and 8 on the other. I will be discussing this issue with my specialist.

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    hi @mimaa we are doing ivf for mfi too. I agree with was me+he&she=three has said. and in addition: have u got a second opinion? not all fs are the same. we changed fs and got our ds the first go with new fs trying different protocol for sperm collection; instead of using ejaculated sperm my dh had a needle biopsy and sperm were taken directly from the testicles. We have done 7 rounds of ivf (5 of them FETs) and only got DS so far. At your age I would think u should be getting more eggs too and your stim protocol needs to be changed. GL

  5. #5
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    I'm at supposed to be at one of the best fertility specialists in melbourne. She has done quiet a bit for us but you are right, we will be getting a second opinion, i have already started doing some research. Just wondering, what is the diagnosis of your husband akakura, if you don't mind me asking? Did you inseminate the fresh cycles you've done all with biopsy retrieved sperm? Or have tried fresh sperm too?

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    My husband has polycystic kidney disease but the cysts aren't just on his kidneys but also they found some in his testicles and the tubes leaving the testicles that the sperm travel thru on their way out. Our first stim cycle at mivf we used ejaculated sperm but the embryos were all low quality as most of dh's sperm is 99.9% dead, poor morphology, low volume but normal count. We swapped to Monash and they recommended biopsy sperm and the sperm are all alive in there! Might not be suitable for your issues but worth asking about.

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    We are also with monash, I will look into needle biopsy TESE. how many eggs were retrieved and how many of them got fertilized by the biopsy retrieved sperm? Also did you use calcium activation in the ICSI to assist in egg sperm binding/fertilization? Thank you and sorry for all the questions

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    We started with male factor infertility. My DH had had a vasectomy. I thought it would be smooth sailing. Our cycles of Ivf revealed that we were actually dealing with female factors also that I had no idea about. Please look at issues on both sides of the fence as you could be dealing with poor quality eggs or declining AMH. I was shocked to find all my eggs gone by the age of 34 and no doubt the decline would have started in my late 20s. So dont let MFI mask other issues that if identified can be addressed to improve your chances.

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    Yes, this is something have a brought up with FS, however, she believes at this age my egg quality should be fine and that the concern was severe MF. How do we determine bad egg quality? Is there a particular test done or we just determine it according to the outcome of the cycles..?

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    I guess if you have done a few protocols not getting may eggs and not getting implantation then you could be looking at female issues. It's a trial and error thing unfortunately. They can do AMH test to check roughly where you are sitting. Never ever did I think my egg reserves would be gone by 34. Get second opinions dr Wazza in Brisbane is a great second opinion. I have cycles from vic and wa with him. Anyway, just didn't want you to be blind sided by thinking everything could be MFI. Are you with Lynn?


 

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