ICSI - did you have it done with your IVF cycle?

[chocolatepie]

Got the call that insurance approved our IVF cycle and would cover assisted hatching but not ICSI unless we had issues down the road.

Weeks ago, the coordinator said they use it just to help further potential for success but my Googling is telling me it's really mostly effective if there are sperm performance issues. DH's sperm is GREAT. We are using IVF due to blocked tubes.

Did your clinic automatically use it for all IVF cycles or is it something you could opt out of? 

[pickel]

Our clinic used it for our cycle but my DH's sperm is/was fine. I wasn't really sure why they used ICSI, only that it was their standard protocol.

[icedcoffee]

I'm pretty sure we could opt out. I did use ICSI though. My H's sperm was the issue so we really had no choice.

[woowoo]

We chose to do it because A) we could afford it OOP as it didn't add that much in cost to everything overall and B) we wanted the best chance for success and our clinic felt it would contribute to that.

[pooh8402]

We used it for all of ours. First cycle, it was protocol. Our second IVF cycle, they attempted natural fertilization but nothing was happening so ICSI it was. Third cycle, we knew the history much better and there was no question. DH has 100% anti sperm antibodies, so it's pretty necessary in our case. He was diagnosed with it between IVF cycles 1 and 2.

[Jalapeñomel]

We just did it today because of MFI.

[megstoo]

The clinic I am at now automatically does it for everyone. The clinic I was at prior didn’t and they would charge extra for it

[kellikans]

We did ICSI for our first IVF cycle because we were unexplained and didn't know if we had fertilization issues or not. We did half ICSI/half natural fertilization. None of the ICSI fertilized eggs made it. For our second IVF cycle, we didn't do any ICSI and still had a good fertilization rate and grew out 2 chromosomal normal embryos, one of which is DS.

Unless there was a concrete reason for doing it, I would opt out. Our second cycle we were also going to be paying oop for pgs, so we didn't want to pile on the cost of ICSI as well if we didn't really need to.

[seeyalater52]

Our clinic also only does it when indicated, although if conventional fertilization goes poorly they will do “rescue ICSI” to try to improve the fertilization rate. I would ask if this is an option if having it as a backup will make you feel better.

It can actually be less desirable if you don’t have a male factor issue as there is a lot that isn’t understood about how the conventional fertilization process functions to select quality sperm absent ICSI.

FWIW our insurance would not approve ICSI and I was worried about not having it but we had 100% fertilization of mature eggs anyways. So ICSI isn’t the only way to have success, which is how I felt when I was doing my cycle and saw that so many clinics opt to do it as standard.

[thoseareradishes]

We were going to do half ICSI half natural for my first IVF but we only got a few eggs so we just did all ICSI to try to up our chances. For IVF 2 and 3, we did PGS so we had to do ICSI (not sure of that is still the recommended protocol, this was few years ago). Actually not sure what they did for our DE IVF cycle - probably ISCI since we did PGS.

[G22]

We did ICSI for both our IVFs. My H has low motility, viscosity and overall numbers. Those swimmers needed all the help they could get.

[cherryvalance]

We did, both times. We actually didn't realize they resorted to ICSI with our first cycle until we were prepping for this past one and going over protocol. We are predominantly MFI, though, so we always knew it might be something we'd need and it was covered for us.

Without MFI concerns and being OOP, I would be willing to try a cycle without and see how it goes.

[stellelinds25]

We’ll be doing it because we are MFI...I can’t imagine they can force you to do it if you don’t want to though!

[pooh8402]

Jan 28, 2019 13:01:06 GMT -5 stellelinds25 said:

We’ll be doing it because we are MFI...I can’t imagine they can force you to do it if you don’t want to though!

Technically though, they *could*, since it's done in the lab while you're still under anesthesia, or recovering from it. With our second cycle, I was still sleeping when the embryologist came out to tell my husband that conventional fertilization wasn't working and he had to move to ICSI. This was discussed ahead of time, but he wanted to confirm before it was actually done.

A shadier place may not tell you and you never find out until you get the bill.

[boiler717]

My clinic does ICSI on 3 eggs no matter what just to be sure something fertilized. We had no MFI, just stage 4 endo and PCOS. Our only eggs that were fertilized were the ICSI ones so I’m so glad our clinic did that.

[megstoo]

Jan 28, 2019 13:01:06 GMT -5 stellelinds25 said:

We’ll be doing it because we are MFI...I can’t imagine they can force you to do it if you don’t want to though!

A lot of clinics now are just adding it to their protocol.  Where I am that's included in your IVF fee whether you want it or not.  Truthfully the 3 of my eggs that got fertilized were because of ICSI.  

[msmerymac]

We used it with our last clinic, but my insurance also covered it. My current insurance only covers it if there's a medical need. We had my H re-tested and, long story short, he did show some issues back in December, but consulted with a urologist who basically told him to stop riding bikes without bike shorts.   He's tested fine since. My insurance will only cover it if there are 2 tests in a row that show sperm performance issues. It's $1700 otherwise. 

Even before I knew it wasn't covered by insurance I began thinking that it might not be the best choice - for our situation, with normal sperm. There's something to be said for just letting the strongest swimmers do their job vs. choosing what *look* like the best ones.