mfi how many embryos etc from icsi with very very low sperm count?

[naty1]

I am wondering how a very low sperm count has affected fertilisation and growth on to embryos/ blastocyst
Our first icsi 7eggs 1/2 fertilized and grown to 3day 1 good quality
The clinic weren't sure but think it was sperm issue why so few fertilized.
We were both 32 at the time (only other issue was pcos for which I was on metformin)
Also wondering if there are many skinny men with this issue?
Just preparing for another round and wondering if anyone has had high fertilisation rates with low sperm count

[Lauren83]

Hello, as ICSI has a higher fertilastion rate than ivf, providing your male factor is just low count and not a quality issue I would of thought fertilastion wasn't an issue


We had low count so got ICSI, we only got 4 eggs due to issues with me but got 100% fertilisation and all top grade, they unfortunately didn't stick around though!

Good luck!

Lauren x

[Shellster52]

Lauren, can I ask, do the statistics actually show that ICSI has a higher fertilisation rate? I would have thought that IVF is higher because it allows the best sperm to penetrate the egg as it naturally would, where as with ICSI, they have to take a guess at which sperm seems best.

Naty, I read a website saying that failure of an egg to fertilise is generally a sperm issue. If it fertilises but is poor quality then it is generally an egg issue. Sorry I can't find the site again to post up the link.

My experience:
My hubby has 100% abnormal sperm.
IVF 1: 1 egg retrieved. Fertilised but disintegrated before ET.
IVF 2: 4 mature eggs retrieved. 2 fertilised normally, 1 fertilised abnormally with only one pro-nuclei and 1 didn't fertilise. 2 embryo's transferred but poor quality. BFN.
IVF 3: 3 mature eggs retrieved. 1 of 3 fertilised. Great quality. 1 transferred but still BFN. (Blaming the hospital getting trainee to do my transfer!)

So as you can see we don't have a great fertilisation rate either which I definitely put down to hubby's sperm. It is interesting that my embryo quality has improved each time so I definitely believe the website that says the embryo quality is up to me because I can see improvements with each IVF and I have been working so hard since my first failed IVF with a high protein diet, acupuncture and supplements.

Oh, if it helps, DH's first sperm analysis showed low count as well as low motility and abnormal morphology (the works!). I studied what supplements can help and after a couple of months, his count and motility were both way up and in the normal range (but still 100% abnormal morph which is the hardest to change without diet which my husband is very slack at). So I would definitely start him on the supplements before your next IVF if low count is the only issue.

One more point is that I tried to have sex every day for 5 days leading up to ER. One study showed that men who ejaculted daily for 7 days had 20% less DNA damage in their sperm. Gets the older sperm out that has been exposed to the bodies oxidation process. Maybe that also helped with our embryo quality?

I have done lots more but will stop for fear of boring you to tears and you can ask any questions you like. But maybe I am not the best person to ask seeing as I am not yet able to score a BFP for myself! Starting IVF again early March.

[naty1]

Thanks for the replies, interesting.
It was such a low count no info on quality as no % possible.
Also he are always told no sex etc for a few days before a sample to get the best quality.
Although before that I have also seen studies saying regular sex helps .

[Shellster52]

Oh okay, so a really low count that supplements might not help. Oh yes - to clarify, same for us too. We are told no sex for a few days before ER, but before the abstinence period I try to have sex heaps (which is more of a chore than for fun!)

I guess at the end of the day there are no set rules with all of this. Next time you could get lucky and all eggs fertilise, or it could go the other way. I tried to do everything to statistically increase my chances and then when I started my last IVF, I started a thread on here and three other women doing IVF at the same time joined in. I felt like I was in with the best chance as I had done so much research and done everything right with my diet and supplements where as the other women were new to IVF and had not yet learned of all these things. Yet everyone on that thread got BFP except me! Although as I said I did have a great quality embryo so I wonder if the hospital having a trainee do the transfer was the issue?

When are you planning on doing IVF again? I am starting in March and paying more for a better clinic so I won't have a trainee do the transfer and they will use ultrasound to put the embryo in the best position so here's hoping.

Sorry to write a novel but can I also ask, I am suprised they only retrieved 7 eggs. I thought that those with PCOS had very high egg reserve because you don't usually ovulate and usually over produce eggs with IVF.

[mammmamia]

Here's my experience:
DH had undescended testicle which wasn't picked up until he was about 7.
As a result he had pretty much zero sperm. No issues with me. On first ICSI treatment I over responded a bit so produced 23 eggs of which 7 fertilised. The embryologist said he struggled to find enough for all the eggs but I guess the ones he found were good quality. I'm guessing our issue was more a quantity than quality issue.
We had two transferred and our twins are nearly four. I wish you all the best.

[Lauren83]

That's what I have been told Shelster, the clinic said it too but I have never done my own research into it so I'm open to being corrected, I just always thought as they injected it directly into the egg you had more chance of fertilisation x

[naty1]

Unfortunately I did over respond I think I had 23 follicles of different sizes worry about ohss even though I was on 2/3 dose I think what was collected were the right size ones.
I suppose it depends icsi ensures they are fertilised but yes ivf gets better sperm .
It would be interesting to see what happens if you do 50/50 ivf to icsi

[Shellster52]

Didn't mean to imply that I am trying to correct you Lauren. Just curious abut the facts. Guess I shouldn't concern myself with it anyway since we are forced to do ICSI. The one thing I am very curious about is how they pick the sperm for ICSI? Have you ever been told that? I went to a cheaper clinic and I wonder if they didn't have the best equipment for selecting the best sperm. Must ask my new IVF clinic that at my appt in 10 days.

So when is your next round Naty?

[naty1]

I wondered that (felt like they'd got mostly dead ones)
Annoying as he could have done another sample or there were some frozen.
I hope it's a different lab tech this time

[SuzanneSays]

Hi Naty,

We had unexplained infertility for 4.5 years, during which time my husbands sperm quality steadily declined. Our clinic told us that as he had a low sperm count, low motility and high morphology ICSI would be the best option over IVF. They explained it as washing the sperm and then choosing the 'best' sperm to fertilise the eggs- not sure what this process involved. They were adamant that this would be more successful than IVF given our circumstances. I produced 16 eggs, of which 10 fertilised, 2 of which were grade A - both transferred , now 10 weeks pregnant (single pregnancy). Unfortunately the other embryos were not thought to be of good enough quality to freeze as apparently when defrosting you can 'lose' cells. Hope this helps!

[naty1]

Congratulations Suzanne. 10 fertilized is really good. Hopefully I was just unlucky last time with the rate of fertilization.

[Lauren83]

I didn't think that at all don't worry I'm just saying I have an open mind as I never did my own research, can't 'bad' sperm sometimes fertilise with ivf? Or 2 sperm together etc? I figured ICSI makes sure they select ones that appear better? But as I know ICSI increases your chance of a child born with defects I know what appears the best might not always be x

[naty1]

It must be difficult for drs to balance the need for pregnancy with the increased risk. Plus it's in their interests to do icsi for cost and I assume success rates.
If I had 3 rounds on nhs and not too bad sperm count ivf would be better.
A friend for unexplained did icsi which was probably the right choice as only 2 embies remained for implantation.
A positive they think ivf/ icsi kids are doing better at school.

[Shellster52]

Mmm, not sure Lauren. I know that 2 sperm can't fertilise an egg naturally because the egg changes chemically once it is fertilised to not allow other sperm in. I don't think I'll go away and research it or it will be another thing I am going to stress about in the lead up to my next IVF that is out of my control.

Interesting Naty1 that you have heard research that IVF/ICSI kids are doing better at school. I wonder if this is really the result of IVF or the fact that these women have been through so much to get pregnant, that they eat super healthy when they are pregnant and spend so much more quality time with their babies/children because they appreciate them more?

[naty1]

I think it would be the latter but I'm sure preconception health probably helps

[Shellster52]

Yes, I'm sure it would be something to do with the parents rather than the fact that they were born through IVF/ICSI. Still, I will remember that seeing as my baby will be IVF/ICS - hopefully if it ever works!

So when are you doing another round Naty. So you say last time you had one good quality. I assume you had that one transferred but BFN? Can I ask what day it was transferred? And did they use ultrasound.

[naty1]

No it was successful she is 20 months so 29 months ago i am now 34.
No there was no US for the transfer though who knows now. I think the placenta was at the front though so maybe not in the greatest position.
I was under the impression the embies can still move around a bit (i saw poss to get ectopic still) but maybe US also solves that.
2 were transferred but 1better quality (also they had written the other off as not fertilized as had not seen it at the time so werent sure it was ok they called that 1pn rather than 2pn i think.
It was done 3 days post ec. Due to messing about with another immature egg to get me the 2. The immature 1 matured but again didnt fertilize. But then they "found" the 1pn one and used that- weird.
But after all that singleton so i presume it was the better egg.
So not sure how ill feel if they try to say 1 embryo only .
most ivf that i know are singletons only 1 twins.
We are only having 1 go as we had accepted when we had her unlikely to have another so enjoyed everything as if only see it once. Also prepared for failure as last round was so close to having none to transfer. I will feel i havent wasted the money if we get to that stage with at least 1.
Shell -did i see that yours is secondary infertility?

I start stimms 4/02 long protocol is really long (i hate the nasal spray the most every 4 hrs is just too much)
Its odd by my estimation last cycle wasn't very successful but it did work. So nothing about the treatment has been changed. I suppose the only diff may be they could trigger later to get more eggs the right size and mature.
I feel the service is really let down by the weekday only for scans and egg collection i think this could affect results.
The ET is done on weekends i suppose less chance of complications and not a consultant a lab tech. (Embryoligist)
An advantage (if there could be one of previous problem is we were already with the clinic only contagious disease bloods and my hormones levels needed before we could be referred) but also we knew the stats so if we were going to try it was worth trying before 35 for the increased chance, would have been sooner but for bf.
I now have hypothyroid which i didnt have diagnosed previously (that could be a pro or a con)