The last two times we did an IVF stimulation cycle, we did not use ICSI (intra-cytoplasmic sperm injection). As I’ve mentioned previously, my husband’s sperm is perfection. Our fertilization rate of mature eggs was over 90% the first time, and just under 80% the second time. (Lower the second time, but because of the small sample size of eggs, maybe not statistically significant.)
But if you want to do PGS, you have to do ICSI… they don’t want to risk biopsy-ing a ride-along sperm.
So we did ICSI. Our fertilization rate was 90%, which is to be expected with good quality eggs and sperm. (Not that we have good quality eggs….)
But, like everything, there are drawbacks to ICSI, discussed here:
A big one is that there’s a chance that the egg will be “broken” during the process. Hopefully not, but it’s a risk. Also, in theory if you put the sperm around the egg the “best” sperm prevails. In ICSI, the technician just looks for a mobile sperm (they might not even be able to catch the biggest and strongest!). So you might not be getting the best sperm. Although it sounds like there’s no medical evidence that the fastest sperm or the sperm that ultimately beats the other to the egg naturally is the best… but it probably is. And the use of ICSI does not appear to increase pregnancy rates, even if it does increase fertilization rates. (Although this could be because male factor issue requiring ICSI may cause a lower success rate. Ie. It’s not ICSI’s fault but the average population using it.)
Also, it’s another expense. Whatever. We didn’t have a choice this time, so we did it. But if it were not necessary—either due to male factor issues or due to PGS—I probably would not do it.
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