Do we really need ICSI?

[BluebellBeanz]

Hi all. My partner and I have been TTC for 5 years. I'm 36, partner is 39. We've had 3 very early miscarriages in that time. My partners semen analysis came back normal but I've been told that I have low ovarian reserve. I also have mild endometriosis and have recently begun treatment for subclinical hypothyroidism and endometritis. We're pursuing both NHS and private routes (after being messed around significantly by NHS) and one private clinic has strongly recommended that we have ICSI. I need to do more research into it but I wondered if anyone could note the benefits of paying extra for ICSI when the SA was good. Is it more to do with the fact that I've only managed to achieve pregnancy 3 times in the 5 years? I have asked the clinic this question but wanted to get some unbiased opinions too - although I do appreciate that advice here is based on experience and rather than fertility experts etc....

Thank you for your help.

I recently listened to a BFN episode (I think it was the 17 Aug 2021 episode) where the couple got loads of eggs and so they did the majority as ICSI but did some as normal IVF. They actually got a higher success rate with normal IVF even though their SA had highlighted issues. Obviously that's only the experience of one person though.

If I was in the same position as you, I would definitely want a second medical opinion and some explanation for why they were recommending it. Can you talk to your GP about it? Or are they part of the problem you've had with the NHS?

I had low reserve and borderline low sperm, the theory is you get better fertilisation with ICSI. So not all eggs fertilise, and not all embryos progress there will be significant drop offs at each stage.

With low reserve you will have less eggs to start with so in theory it improves your chances of getting a viable embryo that implants. ICSI removes the shell from the egg and injects the sperm directly into the egg, with low reserve eggs can be tough and the sperm can have difficulty penetrating the shell.