Infertility and ICSI

[Yorkshire2022]

Hello
So after 2 years of trying and 1 year waiting to be diagnosed by the NHS. They have said my partner as fluctuating sperm results they don't know why this is happening but sometimes it's low in most areas they look at. They've now suggested ICSI I am terrified of IVF and wondered if anyone has any similar experiences. In the 2 years we've been trying we haven't had one positive test! Has anyone got an info on how to improve sperm or ivf has a whole I suffer with health anxiety so undertaking ivf is going to be super stressful which I imagine it is with our without anxiety

I have contacted our ccg as we only get 1 round and we've been told if funding is removed come April we'd loose it if not used by March just to had more pressure :(

I have done ICSI with the IVF. We had mobility issues but no advise on how to improve quality.

We were told the woman to take folic acid to help.

They should give you the paper one to explain it all. Have you had any? Googling can be torture.

Depending on where you are you may be able to ring or send an email with all your questions 😊

Heya, I'm 10+3 pregnant from ICSI we have severe male factor. Had the cycle in August and while there was some discomfort at times with growing ovaries and hormones, it was so so so much better that the months and months of mystery and negative tests and not knowing why we weren't getting pregnant. None of the procedures are that different from fertility investigation except perhaps egg collection, but you're sedated for that and blissfully unaware.

I read up a huge amount about DNA fragmentation and embryo drop off rates so my husband (who has a varicocele causing his low counte, which can't be embolised) did all he could by not drinking alcohol, caffeine, taking proxeed daily, loose boxers and no baths, only showers for 3 months leading up to ICSI. We got 7 eggs and all fertilised, 6 made it to blastocyst and we got lregnant on 2nd transfer which was our first frozen one.

You're well cared for in IVF, and there's counselling available to discuss your health anxiety. It's so much better to be actively doing something than that crushing disappointment each month, truly. Any questions about the minutea of ICSI let me know as its all very fresh in my mind! Xx

Thank you @Purplesmartie12 we have had the generic paperwork to read through. But no information on how to improve sperm or further tests as to why there's sperm problems! We resorted to a boots home test to see if its improved although who knows how accurate that is x

Aww thank you @Imisscoffee2021 that's a huge help and comfort. Did you take any supplements or any particular foods to improve egg quality? I'm thinking of going for it in March to give me time to top up on supplements and try and maximise egg quality although all my tests are good im hopeful i only need one 1 egg collection. Currently taking folic acid, vit D/C and Coq 10.

Did your clinic offer your husband tests on why the sperm results were lower. My Husband hasn't been offered anything just said they don't know why it's like that. I've tried to find a sperm consultant but no luck.

And congratulations to you too Xx

Hi, I am in the same boat and are due to start ICSI in the coming months. Our funding is in place and we have our first app Jan and I believe we'll get going pretty much straight away as all tests etc have been done.

My DH has a bath every day :( wondering if I need to tell him to stop - as well as start taking supplements.

Does him increasing his sperm quality increase success of icsi?

Good luck xx

@Yorkshire2022
My husband has a varicocele, which is a varicose vein, in one testicle which heats things up with backward blood flow. We suspected as much ten years ago when we first got together in our early 20s but GP at the time said no, so after not concieving for 8 months we went to a private urologist at the local hospital and he said right away its a visible severe varicocele! Most men can have this shut off with a procedure and some sperm improvement can be made, but the surgery didn't work for my husband as he's in the 10% of men whose veins are configured in such a way the surgeon couldn't find it! £4 grand down the drain!

So we went with lifestyle changes and put our trust in ICSI. He had between 2 and 3 million sperm on tests, and between 1% and 2% morphology. Forgot to say with that info (that we had found previously to IVF) the clinic advised only a 24 hour abstinence before husbands sample on egg collection day to avoid oxygenation damage to sperm. My husband also aimed to ejaculate every other day in the 3 months lead up to IVF to keep replenishing sperm and avoid DNA damage. Was a slog for the fella but I really think it helped. The maternal genes carry the embryo for the first 3 days then the male takes over and the dreaded drop off happens, so we were shocked to receive the call that all 7 were going strong on days 4 and 5 and just one slowed down day 5 so wasn't frozen. 6 blastocysts out of 7 eggs was an amazingly low attrition rate, was such a surprise and relief!

I read It Starts with the Egg and made some changes from there, took CoQ10 and in 2nd transfer very high dose vit D to aid implantation. I also threw everything but the kitchen sink at myself and stopped using plastic bottles and tupperware, stopped using acidic canned foods like tomatoes due to advice in the it starts with an egg book, stopped wearing nail varnish and only used solid perfume from Lush rather than sprays as it had lots of eye opening scientific advice in that book about chemicals and phthalates etc. Perhaps a bit much but I wanted to do everything so if it didn't work, I knew it was just luck of the draw and not something I could have avoided.

It depends on why your husband has low count as I wouldn't suggest following our routine to a T without knowing more, ejaculating too much may not be good for yours as it was for mine as we knew the cause. It's a minefield and alot of low sperm diagnosis treatment is simply ICSI. My husband was advised to have a cystic fibrosis test which he had but was on NHS so still awaiting results months later, in which time we had IVF and got pregnant! It's often a first port of call in testing low sperm count but my husband has a physiological reason.

Have you chosen a clinic and had the initial tests with them or with NHS?

@elsied16
Hot baths are one of the things advised not to have if there are sperm problems. If hes not having really long hot ones nay not be a huge problem. My husband didn't have loads of baths, prefers showers, but swore off them for 3 months run up to ICSI just to tick ebery box.

I think the more healthy sperm the more the embryologist has to choose from and less liklihood of them choosing one with damage, as they're not able to see on a DNA level in ICSI, there's a procedure called IMSI where more is done to look at the sperm but costs more.

If you have a date for IVF it's easier for the gent to abstain from things that negatively effect sperm, as there's an end goal! My husband was so appreciative of a good coffee, and nice cold beer after giving them up for 3 months :) and luxuriating in a bubble bath, when it was me then who couldn't have a bath after transfers!

Hope your round goes well :)

Hi sorry I couldnt help more there is alot of advise out there for women but not much for men. My husband didn't have any advise. I know BMI does affect the outcome thou.

There is a supplement for men which is wellness man conceive which we used the female version.

The link below might help

www.nhs.uk/common-health-questions/mens-health/how-can-i-improve-my-chances-of-becoming-a-dad/#:~:text=Sperm%20temperature,your%20testicles%20cool%20may%20help.

@Imisscoffee2021 aww thank you so much. What a battfield it is! I think I'll try and find a urologist to find out more.

We are in the same boat as you guys were, no plastics no caffeine we've bought natural deodorant no bad sugars (we're in the trenches)

Were on the NHS but honestly it's not been a good experience it's taken us over a year to get to the treatment stage due to delays which are unavoidable in the nhs but we've had lost tests and paperwork, told not to do tests when we should of done it's been stressful. I think if we have to pay for a 2nd round I wouldn't go there. Our consultant was quite abrupt thinking we had caused delays but was the clinic. Didn't tell my husband they needed a re sample all sorts have gone on! Xx

@Purplesmartie12 thank you so much that is a great help :) xx

@Imisscoffee2021 hi there, just came across your post. Would you mind me asking what was your dna fragmentation?

We’ve had two ICSI+IMSI cycles (and age is on our side for now -34/35)

1. 20 mature eggs only 2 fertilised, both FETs failed, no implantation.
2. 24 mature eggs, 4 fertilised, 2 made it to day 5 which we have now sent off for pgt-a.

Our diagnosis is a significant male factor with dna frag of 48%, low motility and poor morphology. Between the two cycles the hubby has been on proxeed and vitamins but that did not seem to have much of an impact on fertilisation rates…If the two we have will come abnormal, don’t really know what else we can do apart from going through more cycles and hoping for a miracle…the consultant told us above 30% is high but i don’t know if 48% is really bad - logically there should be 52% of good sperm but given our fertilisation does not seem to be the case..

Hi @Pineapple89 , what a journey you've had, hope your two latest blastocysts pass their pgt-a!

We actually never got Dna fragmentation tested, we just knew the morphology, motility and volume was extremely low, too low for natural conception due to the varicocele. I'd read a lot about DNA frag and completely spooked ourselves with it so my husband did a few things to try and counteract it as we paid for a multicycle package so treated the first round as a try. He took the vitamins as all do, but also gave up caffeine and alcohol, stopped having baths and just showers, wore loose boxers and tried to refresh his swimmers every other day to avoid the oxidisation damage you can get from having a varicocele. Because we got 100% fertilisation rate and no drop off after day 3 (til one slowed down on day 5) we figured he'd done something right but we can't know for sure as never had the test sorry :( I'd imagine he would have damaged sperm with the varicocele.

Has your clinic suggested anything else to reduce the fragmentation? X

Thank you so much for your response @Imisscoffee2021! We’ve been previously suggested that testicular sperm may help which gave us some hope but then our clinic was bought out by another one and the new consultant said that the sperm quality may not improve even if retrieved directly from testicles..Keeping fingers and toes crossed for the two blasts we got out of this cycle!

Hi 👋

@Pineapple89 @Imisscoffee2021

Please may I ask if you guys are uk based? My husband has low volume and morphology stating we have a 3 in 100 chance of getting pregnant.

My husband has been offered no investigations or test as to why and the clinic stated they don't know why its happening (has 3 sperm analysis) that's all.

Reading the above it seems partners have been offered explanations as to why and what to do. My husband hasn't been told to take any vitamins or anything. We've googled things we can do but as far as medical advice we've received none.

Any advice would be welcomed :) x

@Yorkshire2022 yes, I am UK based. We’ve had a couple of consultations with the urologist who did all the tests - general semen analysis, dna fragmentation test, genetic testing and we’ve been referred to do icsi straight away. I think we struggle with low fertilisation due to the high dna fragmentation but it definitely is worth doing all the tests to understand the root cause of low motility and morphology. It’s not easy to fix motility or morphology. Medical advice we received so far:

1. vitamins - proxeed for at least three months (or impryl), cq10 vitamins, vitamin D. Can tell you for the fact that the volume in our case went up from 0.5m/ml to 35m/ml and 49m/ml and motility has increased from 5% to 11%. If your issue is just the motility and volume, then supplements can help. It’s worth doing the dna fragmentation test as it seems to be the underlying reason for low quality of the sperm.
2. echoing @Imisscoffee2021 , we were told that frequent ejaculation reduces the dna fragmentation. In the run up to the egg collection, the hubby was advised to ejaculate every other day.
3. sperm takes three months to regenerate, so the advice is to do all the supplements for at least 3 months. We didn’t re-do the dna fragmentation test as it’s quite expensive.
4. we also did the test on the number of chromosomes within the sperm to rule out any genetic diseases. The result came back clean.
5. no hot tubs, hot baths - these have detrimental impact on sperm.
6. we’ve asked about coffee - coffee is ok in moderate doses - 1 cup a day. No alcohol.
7. urologist appointment is worth having as they can find reasons just through examination e.g. if the reason is varicocele. We have a bit of that too but not significant enough to do a surgery.

hope this helps

@Yorkshire2022 we really pushed for our diagnoses and went private alot, spent our lockdown savings as NHS wait times are long in our area.

There's so much debate about varicoceles (our reason for infertility) across trusts and even across urologists in the same hospital that often the NHS doesn't operate anyway unless the man has pain.

After finding out how low my husband's parameters were in Feb 2021 we went to a urologist because we suspected a varicocele, could see it! Having been fobbed off by a GP about it years ago. He advised embolisation as is less invasive than IVF, so we went private again but sadly this didn't work for us.

Paid for an IVF multicycle in May and did the first round in August so spent the run up honing what we could for both of us, with supplements and life style changes. Like @Pineapple89 said above, ejaculating frequently was hugely important to refresh the sperm.

If we hadn't pushed and paid ourselves we'd still be waiting for NHS IVF, went through their referrals as we have two rounds just in case the private didn't work but I'm now 25 weeks pregnant with a little boy from that first round, can't imagine to still be waiting. A lot of things were decisions made from our own research tbh, the only advice from the IVF clinic referencing low sperm parameters was a 24 hour abstinence before egg collection, shorter than if the man has normal parameters.

What stage are you at ATM , is your clinic IVF or fertility?

Thank you both so so much. Honestly I've learnt more from this group than our clinic.

We are nhs and been 2 years due to mistakes made but we haven't invited for a urologist appointment or told what vitamins he should take or lifestyle changes.

We can do ICSI at any point now we get one round funded. But after reading the above I'm now thinking to book in, in 3 months for Icsi so my husband can do the supplements and other bits mentioned to give us the best absolute chance and maybe see a urologist in those 3 months for answers.maybe because we are nhs we haven't been given the urologist options I don't know.

It is just frustrating it was straight to ICSI with no support on why the sperm is low and how if at all to improve results before treatment :(

Not been the most plain sailing of experiences, it got that bad we were at the point of walking away from the clinic and treatment all together told different answers by different staff its made it so much more stressful.

Thank you so much for the help! @Pineapple89 @Imisscoffee2021 X

I've never been given a urologist with NHS @Yorkshire2022 , we booked a private consult and got the varicocele diagnosis. I logged into an online seminar with our IVF clinic before going with them and the consultant said he didn't think varicoceles caused low sperm count, it's a rather controversial topic when they clearly do!

If your husband's parameters are in the extremely low the clinic will want to do some tests first to rule out genetic disorders like cystic fibrosis I believe, ours were borderline so never had it.

We found that for many many clinics, ICSI IS the treatment. You'd think it would be the last resort wouldn't you? But no, IVF/ICSI is the go to treatment for low sperm parameters, such an invasive thing!

Thank you @Imisscoffee2021xx

How did you find a private urologist we've looked via Google and struggled to find one before.

I agree isn't it bonkers, you'd think they'd try and help the male factor before jumping in to icsi and ivf.

Did the proxeed help you guys enough. Do you think it is worth it to push the treatment back just whilst we get on proxeed and try and make a difference before egg collection. We're not desperate to start icsi just yet after all the mistakes I need a breather for my body to recharge but now hearing proxeed and other vitamins I'm thinking the 3 months could make a difference to try and enhance success. We had one borderline result but was classed as normal. Second test was low in morphology and volume then even lower on the 3rd sample. I bet the stress doesn't help either x

@Yorkshire2022 we googled and found one operating out of our local hospital, seems quite common practice.

Unfortunately I can't give a proper clinical answer about the benefits of vitamins and lifestyle changes etc, as we only had the one round of egg collection. My husband has a severe varicocele with very very low parameters and we got 100% fertilisation rate, and 6 of 7 to good or top quality blastocysts. We were waiting for the bad news all the way and were so shocked at the results! The fresh transfer didn't take but the first frozen one did so we have 4 more on ice. Can't say if it was all the changes my husband made for sure but I'd read so many threads of people losing embryos too they'd done some tackling of the male factor. My husband took proxeed some days and Wellman max conception others as he hated proceed so we didn't follow it to the letter.

You've probably read Jonathan Ramsay's name alot as many go to him for male factor and he seems to find underlying infections etc causing it, and antibiotics help etc but he's London based and pricey.

Thank you! Huge huge help and given us a route to explore.

Did your husband take said supplements for a period of time before treatment?

Yeah he did, started in the may when we paid for the treatment to egg collection late August. We didn't plan that long between just the way my cycles lined up following their routine tests like amh and follicle count but like @Pineapple89 said sperm production is a 3 months cycle so supplementing and refreshing was so important for us to know we had done everything we possibly could. I also followed the it starts with an egg book advice to make sure my egg quality was as good as I could influence it. Hope all goes well do update on here :)

@Yorkshire2022 @Purplesmartie12 Thank you both for this thread and all the valuable insights you've provided. It's truly uplifting to read about real-life experiences. I've been feeling a bit overwhelmed reading through Google, but your first hand accounts are reassuring. I have my initial consultation appointment scheduled for next week to discuss the next steps for ICSI.
I hope you don't mind me seeking your advice — could you suggest any crucial questions I should ask during the consultation? I'm also curious about how you both are progressing. My DH is also going through the varicose operation, so I'm hopeful this will be beneficial for us. Thanks once again! x

Hi all im not sure if this place is the right place to post, i have low AMH levels im 35 y/o and i was looking to go with CREATE fertility Birmingham. I wanted to ask your experience with them if you did or have gone with them? Thank you x