sharedjourney home

Karystos~I see you posted to this site and this dr. is gone. Post this to Dr. Jacobs on Fertility 101 and he'll reply tomorrow morning (usually). Take care and remember to breathe ;)!

Reply

I am concerned about potential abnormalities in ICSI children. It is not the ICSI process that worries me, but rather, the genetic make up of the sperm. It is my only option as we did IVF but the sperm did not bind to the egg. I would appreciate your comments on this.

Reply

Dear Doctor,
I am 32 and my husband is 37 and we have just had our 1st cycle of ICSI. I responded well to the drugs and produced 12 eggs of which 9 were mature enough, 3 were said to be immature and by English law could not be injected. Of the 9 mature ones, 3 fertilised abnormally and 6 did not fertilise at all. Obviously we are both devastated. We cannot understand how this could have happened. I have blocked fallopian tubes but are otherwise fine and my husband has 98% abnormal forms (morphology). His count this time was about average and he has a 6 year old daughter from a previous relationship. I have conceived twice before at a very young age (16 years ago). We dont know what to think, we trust our clinic and what they have said but we cannot help but think that human error could have played a part in this. The clinic had a power cut before we arrived and was running from generated power. Saying that we have been told ICSI was performed on other couples the same day and was successful. We have decided that we will have another attempt but we wondered what tests could be done on my husbands sperm? The consultant said that it could the eggs or it could be the sperm. Is there some sort of DNA test he could have before we set ourselves up for more heartache? They also mentioned something about the sperm breaking down??
Is this what you refer to as decondensaton?
Any advice would be greatly appreciated.
Many thanks,
Steve and Melanie

Reply

I am trying to get a handle on our likelihood of success with IVF/ICSI and have found some very helpful information here. I am 36 and do not have a factor, except that one year ago I had a fibroid removed in preparation for IVF. (It was my understanding that the fibroid would not necessarily have effected my fertility but since my husband has severe ogliozoospermia and we were going to have to go the IVF/ICSI route, removing the fibroid was indicated to make sure my uterus is as friendly as possible.) My husband had TESA done a week and a half ago and just had a follow up with his urologist who said that the two vials they were able to freeze from the procedure were adequate for moving forward with IVF/ICSI. A couple questions:
1. Everything I read gives a much higher rate for IVF with fresh donor egg. Why is this? If I don't have a factor would this not apply and does it in fact give us a bit better chance on my end? I do understand that IVF/ICSI has only about a 20%-30% chance of producing a live birth overall, but is this at all improved by not having a female factor?
2. My husband tried twice to produce sperm for freezing before the TESA, but had only a couple of poor quality sperm the first time and none detectable the second - nothing that could be stored, anyway. For the past two and half months, leading up to the TESA he was seeing a acupuncturist recommended by our clinic and taking many vitamins and herbs prescribed by the acupuncturist. Of course, we have no way of knowing if this helped, but on the chance that it did, would you recommend he try to produce and store another sample before my procedure? I'm worried that the two viles won't be adequate after all as I understand that even though they are deemed adequate to proceed with the procedure that doesn't guarantee the sperm will be good the day of.
3. A related question: our Dr. said he wants my husband to try and produce sperm the day my eggs are harvested. Didn't you say that with ICSI that fresh sperm isn't any better than frozen sperm? Is this just to try and get sperm to use so that we might not have to use the viles in case we need to go another round and don't want to put my husband through another TESA?

Thank you very much for your response.

Reply

I just turned 36 one month ago and my husband is nearly 38. His semen analysis was normal motility and morphology with only slight decreased forward motility (slight enough that our RE didn't even address it as any impediment - we read it in our report).

We have recently been diagnosed with diminished ovarian reserve. We had two unsuccessful IUI cycles before the diagnosis was confirmed by a low AMH level. After doing some research, we decided to pursue IVF, even if we had few follicles stimulated with ovarian stimulation protocols. This cycle, I had 3 follicles. We went ahead with IVF retrieval knowing that we may not retrieve even one egg. My RE thought the 3rd follicle might be a cyst.
The RE was able to retrieve one egg (the other follicle was either inacessible or in danger of injury to my iliac vessels so no egg was retrieved from that follicle). The one egg has fertilized via ICSI and we have instructed the embryologist to use his judgment regarding assisted hatching. Tomorrow is our scheduled transfer. What are our chances for success with a one embryo, day-3 transfer? We would appreciate your candor.

Reply

Dr. Smith,
Following up on the prior facts pressented, we were informed today that the embreyo transferred had 5 cells and was Grade 2.
I should also inform you that I started acupuncture about 3 weeks prior to this transfer.
Your insight is invaluable to us.

Reply

Shokr -

Just FYI...Dr. Smith no longer posts here. Dr. Jacobs does answer postings on the Infertility 101 forum.

Reply

Thanks for the heads-up, wolffie. I reposted to Dr. Jacob's forum.

Congratulations on your baby.

Reply

Dr. Smith,


My husband and I have been trying for a baby for over 2 years. We recently went through with fertility testing. Everything seems to be just fine with me. My husband on the other hand had a varicocele surgery, and a biopsy of the testes was taken. The results came back, he was diagnosed with Non Obstructive Azoospermia with maturation arrest, the doctor did say the condition had to do with a Y chromosome abnormality. The urologist did not fully explain what this meant except that there was nothing that he could do to treat the condition. He did express to us that my husband was producing sperm, but it was only reaching the second stage of development. He suggested that we try to find a fertility clinic that could do ICSI and IVF using secondary spermocytes(my husbands). We have not found one yet, only found clinics that will help in choosing a sperm donor. We are not ready to give up on using our own sperm just yet, but are we fighting a battle that cannot be won? Are there fertility treatments for people that have our issues? Everything I have read about ICSI says this is likely not going to help us.I contacted a professor at the at the State University of New York, who told me about a procedure called ROSI or ROSNI (round spermatid nuclei injection). The professor did mention that this is a very controversial practice. I have not found very much info on the procedure except that it is being tested on mice, and a few procedures have taken place in the middle east? I am very confused and overwhelmed with the whole situation. We want to have children but are unsure if there is any hope for us! Do you have any info that can help? I hope I have provided you with enough information to help us.

Thanks,
Sarah and Bill

Reply

Hello, I'm new and very happy to see this site exists. My husband had testicular cancer and nobody told us about banking sperm. Now he has retrograde ejaculation. We are going to try IVF and ICSI. I'm 32 and all my labs have looked normal, but I am supper fearful that it might not work. Can you give me a percentage success rate of me becoming pregnant on the first try? Any recommendations on how to increase my chances?

Thhank you,

R

Reply

Dr. Smith,

First of all, I greatly appreciate your participation in this forum. I'm a Registered Nurse, 28 years old and my husband is also 28. To make a very long story short, we went to an infertility specialist and found my husband has antisperm antibodies and my profile came back completely normal. He's suggesting IVF with ICSI. I have a few questions that I'd love to have answered by a physician that's not associated in the care.

1. Are there chromosomal changes with the DNA in sperm coated with antisperm antibodies? Does it damage the sperm other than "slowing it down" as my dr said? If so, what are the chances of having children with trisomy 13, etc.

2. One article I found suggested genetic counseling prior to undergoing ICSI. Do you think this is necessary for ASA or is this primarly for cases in which genetics cause the infertility?

3. He said my husband has ASA on 65% of his sperm after 4 hours of collection. Are they not able to do typical IVF and use the sperm that's not visibly coated with these? Or is it assumed that the other sperm will develop them before implantation can occur? IVF alone will be almost half the cost vs with ICSI.


4. What are the long term possible side effects with the process of egg retrieval, etc. Are there risks of permanent damage to the ovaries? Can you suggest them taking the eggs from one ovary, incase of scarring or permanent damage?

5. I asked if he would try implaning two, since I would honestly love to have twins. He said he would only do one per cycle and at $13,000 out of pocket upfront, with subsequent cycles being $2000-$3000. Is this(only doing 1) typical or is he just trying to get more money? As a nurse, I know my rights to my health care decisions (as well as his to decline and do what he thinks is more medically sound). Is this something that would be inappropriate to push?


I GREATLY appreciate your time. This is so frustrating, but after trying for three years we now know the cause. Being in the medical field has great advantages, but makes you so very weary of treatment. Thank you again for your time.

Reply