ICSI vs sperm donation... impossible decisions!

[malefactorwoes]

Hello everyone

Just looking for some support/ hand holding really, and wondering if anyone has been through similar. It is heart breaking making these decisions when you never even thought it would be an issue :(

So my DH has a very low sperm count due to undescended testes which were not operated on until he was 10. This has been devastating for us, we have not been able to conceive naturally and told that we will need ICSI in order to conceive.

We have a couple of worries about this...

The main one is that, because of the late operation on my DH, there could be damage to his sperm. He is currently undergoing more detailed tests and we're waiting for results to find out more information about just how much damage.

There is a chance that we could go ahead with ICSI, they pick out a sperm that looks healthy, but actually there is DNA damage they can't see, and we end up having a child with a disability. We would love that child of course, but ideally we want to give the baby the best chance of being born healthy. I know there is always a risk, but it seems there is a higher chance it will happen to our child if we use ICSI.

So we come onto considering a sperm donor instead. My DH feels that if we were to use a sperm donor, he would love that child just the same as if it were his own - he has no issues at all with that. But he worries about how the child might feel as they get older - whether they would not feel as connected to him, whether they would shout "You're not my real dad!" as a teenager, whether they'd go off looking for their birth father. It just seems fraught with possible future complications :(

Has anyone else been in the position of making a decision like this? How on earth did you reach a decision? Please tell me any positive stories you have of ICSI and sperm donation as well... I need a bit of a hand hold I think!

Such a difficult decision for you. We were very much sold as ‘there is now a procedure which means you and DH will be able to have your own child’. This was pre smartphone/internet days so there really wasn’t much research we could do.
I will always wonder if the 4 miscarriages were due to the ICSI procedure and if our, much wanted, DS’s ASD/ADHD is due to ICSI.
www.ncbi.nlm.nih.gov/pmc/articles/PMC5384197/
There should be a counsellor attached to your fertility clinic, maybe speak to them and discuss your concerns.
Obviously the positive is that we had our gorgeous DS and we love him dearly

Hi OP, just a thought If it's the use of ICSI itself that is the dilemma - I had two ivf cycles with donor sperm and both times they used ICSI due to the donor sperm having been frozen.

So your choice might be ICSI with DH's sperm v. ICSI with donor sperm? Can the clinic advise on how successful they think ICSI would be at overcoming the MFI issues? As they cherry pick the sperm for it they only need a few good'uns!

I meant to say also - could PGS testing then pick up any DNA issues?

I would do surgical sperm removal and PGS testing before moving to donor sperm.

@ForeverAintEnough12

I would do surgical sperm removal and PGS testing before moving to donor sperm.

I'd agree with this. For me use of donors should always absolutely be the last resort and even then it's not something that myself and DH would have been comfortable doing - it's a very personal choice

@malefactorwoes My story is very much the same as yours. Me and DH we're trying to conceive for a while with no luck before we went to see our GP.

They started tests on me which all came back fine so then started on him and the same as your DH he also has undescended testicles. We believe he was about age 4 according to his mum when he had the op.

It has been a rollercoaster ride since.. and after a lot of conversations between ourselves, our NHS consultant and even a private consultant we went to see we have decided to with donor sperm. It was not an easy decision at all. But feel it is best for us.

We have only recently made this decision so moving on to the next steps now and currently undergoing counciling which is really helpful in is making our choices.
She recommended we look at the donor conception network which is a website with a lot of information.

It sucks though doesn't it? And male factor infertility is not talked about very much so it's really hard to find information and how people feel/handle it.

@malefactorwoes hello, sorry I don’t have any information as am behind you in the timeline but in a similar position it seems. So wanted to share sympathy with you. Like @popcornbella says it just doesn’t seem as talked about/understood does it?
I also wanted to say that if you do a deep dive of threads about sperm donors on Mumsnet, I saw quite a few with both mums with grown up/big children from donor sperm who sounded very happy and also adults whose parents had used donor sperm who also sounded happy and accepting of it. I think there as one person who seemed less at peace with their origins on the thread I’m thinking of. Sorry I can’t find links to the threads. Maybe you’ve already seen them.
I do understand I think some of your or your husband’s concerns. I have some adopted family members who have struggled with a sense of belonging. It is very difficult. And the uncertainty of whether one actually will go down that route or will be able to use husband’s sperm.. it is really hard not knowing either way isn’t it? Sorry if this is a bit off topic. Best wishes to everyone.

Hi, I would also do ICSI with PGS test as the first step. I was in a similar boat, our sperm also not ideal and they suggested the genetic testing on embryos. I went for treatment abroad- with Praga Medica and they use ICSI as a standard.
Best of luck!

@Cyberworrier thank you. I've not seen these posts but I will have to try and find them. Really not a lot of information out there. It's so hard to know what to do for the best. I know woman use egg donors all the time but you don't hear much at all about sperm donor.