IMSI - anyone had it?

[CatnipMouse]

We had ICSI for our first go at IVF with some success, the fresh one that was replaced didn't implant but I got pregnant with a frozen one afterwards. Sadly it ended in a miscarriage. We're ready to try again now though.

We went back to the clinic recently and the consultant suggested IMSI for the next fresh cycle, where they use a more powerful microscope to select the best of the sperm bunch to use. It will cost a little bit more but only about £200 or so. I was wondering if anyone else has used IMSI, or if you have done any background reading or seen any good evidence for it that you could share with me? Thank you!

bumpety bump

Hi - do they think the issue lies with the sperm quality then and nothing to do with implantation on your part? Only asking because I'm confused about this area myself....

I would definitely do IMSI though if you can afford it.

Sorry for your loss. It's a great height to fall from emotionally and takes a lot to do it all again

Thanks allchat (sorry to be slow getting back) and thanks for the

I think it's a mix of things, sperm quality is definitely one, but I think my age is another as my eggs are getting on a bit now. I don't know if IMSI will help with the egg side of things - perhaps just that they are more likely to fertilise if they spend longer picking the perfect sperms? I don't think there are implantation issues as there has been some success on that front at least...

I can't really see much reason not to go for the IMSI, I suppose it feels a little bit as if the random element is even more removed, but that's not very rational as it's really not so different to ICSI.

We did HA sperm selection for our last few ICSI attempts. DH has 100% abnormal sperm but I was days away from turning 38 at my last EC so I am sure egg age was an issue for me too. I saw it on our clinic price list and went home and researched it and read only positive things about it - how it mimics what happens inside the woman in the natural sperm selection process, how sperm selected through HA have been shown to have far less DNA damage. The last two IVF cycles with ICSI and HA produced two top quality day 3 embryos for transfer each cycle which was an improvement from previous cycles. Hard to know if that was the reason, as I also added acupuncture to the mix and also did the high protein low carb diet for egg quality. Have you read that study - showing that a diet of less than 40% carbs and greater than 25% protein increases number of embryos that grow to blast to 50% and the preg success rate to 80%! When you say 'my eggs are getting on a bit now', I'm not sure how old you are, and I know this diet can't reduce the number of genetically abnormal eggs, but I suppose it just ensures that any of our aged few normal eggs have the best chance of surviving the distance.

Sorry, I might be adding more suggestions and more confusion rather than answering your question! I guess what I am saying in summary is that I threw everything into the mix in my desperation for ICSI to work so that I would have no regrets and no wondering 'what if...' so if the clinic offered me IMSI, I would have snatched it up.

shellster52 - hiya! I'm not sure whether I wrote on any other board, but massive congrats from me. You certainly deserve it. Hope you are enjoying your growing tum!

Good luck catnip x

Thank you allchat. I think so far my tum is growing more from enjoying a few naughty foods after being so deprived with 2 years of strict IVF low carb high protein dieting, rather than the 5cm baby in there. How is everything with you. I've lost track a bit.

Ah, well I'm sure I'd be shovelling treats down if I were you. It's happiness and finally you can treat yourself. You've been amazing.

Pretty shit in my camp. Even though I don't have a history of mc, we decided that neither of us believed in unexplained secondary fertility so we had the NK cell test and dna frag tests. So, I have high nk cells which would apparently need to be treated during and ivf cycle and his dna frag is ridiculously high (48%) - which I find confusing because his sperm was fine and we had good embryos last time.

Anyway, finally decided to go to Zita west and book a urologist for him. We'll see.

x

Sorry to hear things are pretty crap for you. It feels like it's all to easy for me to dish out advice now that I have my BFP, so I darent do that... and I don't know what the answer is anyway. I don't know what normal DNA fragmentation rate should be to know how high $48% is, but that does sound high. I read a book called 'Infertility, the hidden causes' by Dr Sandra CABOT, which said a study showed that men who ejaculated for 5 days consecutively had 20% less DNA damage compared to before the 5 days. So I had hubby do that before his IVF sample. I also did HA sperm selection for IVF, which studies shows selects the sperm with less DNA damage (and also apparently mimics our bodies natural sperm selection where only the sperm that emit their HA receptors can penetrate the egg). Don't know if that's any help or if you are not planning IVF again. I really feel for you. It drove me insane when people said 'at least you have one'. Secondary infertility hurts too!

under 25% - no significant problem
25% PLUS - high risk of infertility
25%-49% - no fucking hope without ivf or icsi....

Going to see a urologist soon. I'm hoping he's really going to help explain things plus dh on lots of other medicine for a separate condition and no-one really knows how the drugs affect sperm.

Yep, it's taken me a while to get to this point but it's been a year since last ivf and that's too long really so I must crack on.

To think I always wanted 3 kids!

I think you should always dish out advise. We all need it x

Geepers, that does sound significant. I can't even see how IVF or ICSI would work around the damaged sperm DNA issue if they chose one of those 48% sperm. Did hubby abstain for a period of time before the test? I wonder if that study would prove true in his case and if he ejaculated for 5 consecutive days before repeating the test, it would come back at 20% lower. Or like you say, who knows how a host of other meds affects sperm - it doesn't seem to be something they test before they put any medicines on the market. I really hope the urologist is able to provide answers and gives you a sense of hope.

Perhaps find a clinic that does the HA sperm selection which selects the sperm with the least DNA damage if you decide on IVF again. Easy for me to say and in theory it makes sense to try IVF again with additional HA sperm selection to work around this new found problem, but obviously emotionally it's an entirely different matter. We are all so different, for me I was doing IVF after IVF because moving on to a new IVF with new hope was the only way of coping with the heartbreak of the failure. You obviously need a break in between so you have to do what is best for you.

Dh wasn't told anything before the test. I think we just concluded to do the same for ivf and abstain for 72 hours.
I don't see how imsi would work either, hence the urologist meeting being very important to us. Luckily got a cancellation, so we are going there within a week.

Looking at zita west for next round of ivf so I think they do pretty much everything!

We are having to pay, so when we had a natural conception (that was a chemical pregnancy) the month after the fresh failed cycle it made us believe we could really do it ourselves. Plus the consultant after the failed frozen transfer (that was 2 months fate the chemical) said in her opinion we'd be pregnant naturally within a year. Good thing she's not a betting woman!
We agreed to try for 6 months, then when we got to May we went to the Lister. Dicked us around and then I spent few months getting money back off them and then it was the summer!

Ah in a nusthell! x

I remember your natural pregnancy after your failed IVF. I remember your posts and you were so excited. Then I remember the miscarriage not long after and just how shattered you were. What a roller coaster.

From what I read, IMSI is different to the HA sperm selection I had with my cycle. Only the sperm that are normal are able to emit their HA receptors and so that is why they put them in the HA medium to see which ones bind and hence do not have the DNA damage. Studies have proven these sperm have the least DNA damage so it seems it would be useful in our case. And I definitely believed it helped ours since we used it on the last two cycles and had a brief pregnancy the first cycle and a successful pregnancy (I hope!) the second. IMSI is different as this is using a more powerful microscope and a scientists human eye to select the best sperm. In my opinion, if they have a better quality microscope in the lab, why not use it for all patients?! Why charge extra for the scientist to look through a higher power microscope that is sitting there in the lab anyway?! This IVF is such a money grab. Grr.

I met with two women yesterday I have not seen in a fair while. Last time I spoke to one, she was about to turn 40 and saying she was trying for a second. Having done loads of research during my failed IVF cycles, I knew the stats and her low chance at 40 and I felt like I would finally know someone who understood. Yet turns out she 17 weeks pregnant and about to turn 41 in Feb! And the second lady was pregnant with her 3rd and she too is now 40! It just didn't seem fair that I struggled from age 35 and had to go to hell and back for 4 years with 11 IVF attempts and am now broke to be able to get pregnant. I hoped I would be over the infuriation at the unfairness of it all once I got pregnant, but it seems this journey has changed me into a bitter jealous woman for life!

I am glad your urologist appointment has been moved forward. Look forward to hearing how you get on and I really hope it gives you a sense of hope.