IVF until we all get our bfp! 2012-present *13 w/twins & 1 w/triplets!*

[haj624]

Hi Everyone,

Mrs C asked me to stop by and weigh in on the 100% ICSI v. not 100% topic.

My situation was that I had been diagnosed with PCOS but was not ovulating regularly. DHs sperm came back ok - morph was a little low but the RE wasn't concerned about it. The feeling was that once I would ovulate it would be fine. However we did 6 IUIs and no luck, even with 3-5 follies on most attempts. When we started down the IVF road I suggested ICSI to my RE because I was concerned at my age (38) there might be an issue of my eggs making it harder for sperm to penetrate. We discussed doing at least half, or more depending on how many eggs we got. I certainly didn't want to risk having few or zero fertilize due to a sperm penetration issue but was also curious if that was our problem. If we had ended up with 10 or fewer I likely would have said 100% IUI but that ended up not happening.

Fast forward to Jan and my IVF cycle. They were agressive with meds because I had only gotten 2 follies for an injectible IUI at 150. My dosages are in my signature if you are curious. At ER I ended up with 38 eggs! (Also my age which the people at the clinic were amused by ) Since there were so many the embryologist and RE went ahead and did 50/50 as we had discussed. If I had done no ICSI based on number of eggs I likely would not be pregnant today.

Of the 38 eggs, 28 were mature. 2 were lost during the ICSI process. Of the 26 remaining, 13 were ICSI and 13 were not. Of the 13 ICSI we had 7 fertilize. Of the 13 non-ICSI only 2 fertilized. If we had not done ICSI only a handful would likely have fertilized. As it was we ended up with 9 fertilizing and 6 eventually making it to blast. At 5dt we transferred 1 blast and 2 morulas. No blasts were high enough quality to freeze.

So to sum up it turned out we had both an egg and a sperm issue and we never would have known that without doing 50/50. I could probably have ttc naturally or done IUIs forever and never gotten a sniff of a BFP. For this reason I am a big advocate of doing at least some ICSI, even if your RE doesn't think you need it. If we hadn't we would have found out the hard way by only having 2 or 3 fertilize at all and potentially none to transfer. There are too many stories on BnB where that happens already and it is largely solved with doing at least partial ICSI.

One thing to keep in mind when deciding how many to ICSI is cost since some clinics charge per 10 eggs that you ICSI. I suggested to one poster that she decide ahead of time a threshold for doing ICSI. For example: under 10 do 100%, 10-15 do 75%, 15+ do 50% (or whatever you feel comfortable with). You don't want to be faced with that decision for the first time the day of your ER.

It is really a personal decision what you decide to do regarding ICSI, but I am a big advocate of doing at least some regardless of whether your RE thinks it is needed. It can cost a little more but by the time you pay for an IVF cycle you don't want to end up with nothing to tranfer for the sake of the cost of ICSI.

We also discussed assisted hatching for the same reason but since we did a 5dt and they looked ready to hatch on their own we ended up not needing to. But that is something else to consider discussing with your RE ahead of time if you think it might be an issue for you.

My whole saga, including my 10 days in the hospital after developing OHSS during my IVF cycle, is in the 1st post of my pregnancy journal if you are curious. OHSS is also something I advise educating yourself on since it is NO fun at all, but that is another topic

Good luck to all of you as you go through your IVF cycles

Thank you so much for all that info. I was actually the one who brought up the question. My husband and I are doing IVF with ICSI in May. I have PCOS and my cd21 bloods showed I wasn't ovulating. But our bigger issue is mf. DH's morphology at last check was 2%. Thats why we're doing the ICSI. I was trying to figure out if letting any sperm try to meet the egg "naturally" should even be an option since 98% of his sperm are abnormal and cant penetrate the egg.

 

[Mrs. Bear]

What are his counts? 2% of a high count is still a lot of good sperm. I would base your decision on number of eggs if you think you might want to let some try naturally. If you would rather not, just go ahead and do 100% and don't worry about whether they could have done it on their own. The end goal is good embies however they get there.

We didn't have an obvious MF issue so that didn't weigh into our decision so much as my concern about my old lady eggs. Based on each of our individual situations you just have to do what you feel comfortable with. Good luck!

 

[haj624]

What are his counts? 2% of a high count is still a lot of good sperm. I would base your decision on number of eggs if you think you might want to let some try naturally. If you would rather not, just go ahead and do 100% and don't worry about whether they could have done it on their own. The end goal is good embies however they get there.

We didn't have an obvious MF issue so that didn't weigh into our decision so much as my concern about my old lady eggs. Based on each of our individual situations you just have to do what you feel comfortable with. Good luck!

His counts have been high which is very good but I'm just nervous because I dont want to "waste" any eggs. Thank you for your advice!!!

 

[MrsC8776]

Thanks Mrs. Bear! One more question for you and I know it was brought up earlier as well. What is the difference between blasts and morulas?

 

[drsquid]

so im hopping over here and recognize bunches of you, so yay =)

did 4 failed iuis (only to find out there was an apparent male factor).. was going to do a natural cycle this month but apparently if i do that it wont time out for ivf in june (im off the week of the 11th so it has to be that week) and my doc is going away for most of july. so.. here i am. still unsure how i feel about it. but.. onwards and upwards i suppose

because im using donor sperm icsi has been highly recommended.. my doc keeps saying he thinks the problem is my eggs not the crap sperm but.. so if i do all icsi im not sure if ill be able to know how my eggs actually were. there is a set price for ivf wo icsi, 50:50 and 100% icsi. i guess i might as well do 100%. in for a penny in for a pound right? they are supposed to call me tomorrow to let me know what the schedule will be for meds. at least i have a stock in the fridge which were supposed to be used for this injectible cycle.

 

[MrsC8776]

Welcome drsquid I'm still following the other threads you are in and I have been reading about your struggle with the place/sperm you are using. I'm so sorry that it has been such a difficult journey for you. I really hope that IVF can help you become a mom. I'm glad to have you in here but also sad to see that you have to do IVF.

Is there another clinic you could possibly check into before moving to IVF? I ask because you don't think it's your eggs but the sperm you have been using.

 

[drsquid]

well i got different sperm and i know it has a good count (bank defrosted a vial from the same day as the ones they sent me). i looked into changing clinics but.. other major issues were mentioned repeatedly that being never seeing the same doc, not getting phone calls back, things not getting done, feeling like you are getting herded through etc. other than the sperm issue (which im not discounting, and it shoulda been tested) and being told my eggs are old,. i feel like the doc is good. he is super into evidence based medicine which is a big thing for me. he is aggressive which is good (he didnt dink around with low doses and canceled cycles.. i looked up info about gonal and the recommended starting dose over 35 is 225 which is what he used and i had a fab response). the big argument against my clinic was that they didnt have a strong lab director which i didnt care about cause i was doing iui.. their embryologist quit so now i get the best of both worlds in that i can pick which of the two other centers have better success rates etc and go there for egg retrieval and transfer and icsi but still have the benefit of a doc that i can get in to see whenever i want, i can text him with questions etc. i felt like there was something wrong with the sperm and i should have been pushier about it too. maybe it would have worked if i switched donors after the first cycle but who knows.

 

[MrsC8776]

From what you just said it sounds like you have a good dr. so that is a positive. The other clinic you are talking about that isn't so good sounds like the one I switched from. It's not a good situation to be in when they take forever to call back, don't get things done, and always seeing someone different. I think staying where you are compared to the other place is a good move. If he thinks IVF will work for you then you should trust him. I know it's a big step but it will so be worth it in the end.

 

[Mrs. Bear]

Thanks Mrs. Bear! One more question for you and I know it was brought up earlier as well. What is the difference between blasts and morulas?

Morula is the stage between embryo and blast. So on day 5 a more slow to develop embryo could still be a morula rather than an official blast.

If you do end up transferring any morulas try not to feel like it is a negative. A good morula could be better to transfer than an iffy fragmented blast. The benefit of 5dt is they can tell better which are developing best, not to get to a specific stage. Lots of ladies have gotten bfps with morulas. At least one of my twins has to have been a morula at transfer and it is possible they both were from the morulas

 

[alscreetch]

Casper- That is soooo exciting... congrats on your BFP
Smileykez- Miracles do happen... congrats on au'natural!!!

Welcome Annette So glad you joined us!
Welcome Drsguild So glad you joined us!
Welcome Polly So glad you joined us! It's ok to be scared, we all are!

Lulu- So sorry you were in pain girlie, but 20 follies is eggcellent!!

JDH- Sooooo very sorry for your loss chica. You are in my prayers!!

TTB- I am not sure why some are on the long or short protocols. I would assume that our RE's have done this so much that all the pretesting would say who would need which protocol. This is my best guess... LOL

Dancing- Good Luck at ER!!! I am eggcited for you!!

Blue- I watched the show... That is too cool!! I was like I know her (well sort of) LOL I agree with S08 they really danced around the true pain of IF, but at least there was some recognition.

Haj- We both have our appointments this Friday, just two days left! Hopefully we will be stimming soon!!!

Waiting- As for the meds. I am going to assume that the prior diagnosis, all the pretesting, costs, and specific RE has something to do with who is on what. Correct me if I am wrong ladies. But in my case I was going to go with Gonal because it was cheaper than the Follistim (My RE prefers Follistim) but I lucked up and was able to obtain the Follistim.

Michelle- I will be praying for AF to come!! Looks like anyday now...

Mobaby- LOL on the twin dreams. I too have been having crazy dreams. I had the craziest dream ever. I actually was cracking up in my sleep and woke up laughing. My hubby was standing over me like wtf... My embryo's were in the dishes, but the dishes were club scenes. There were lots of embies (females) but two were DIVA embryo's. They were standing there talking to each other like look at these fools. You get the picture. When the sperm enter the "club" they were racing to get to the diva embies, some were ghetto sperm, some were carrolton, some were jocks etc. But they were pushing and shoving, cussing, and fighting. Long story short two spermies entered the diva's and they started doing the snake (dance) and talking mess to the others left outside. I woke up at the snake dancing part. I laughed all day about that dream!

Mrs C- Again thanks for maintaining this growing board of wonderful ladies! We appreciate you!!! Also, don't worry about the timing with hubby... Everything will work out!!

To any ladies that I left out... I will catch you on the next round!! Feeling easy breezy today! Hope you all enjoy this wonderful Tuesday!

 

[haj624]

Casper- That is soooo exciting... congrats on your BFP
Smileykez- Miracles do happen... congrats on au'natural!!!

Welcome Annette So glad you joined us!
Welcome Drsguild So glad you joined us!
Welcome Polly So glad you joined us! It's ok to be scared, we all are!

Lulu- So sorry you were in pain girlie, but 20 follies is eggcellent!!

JDH- Sooooo very sorry for your loss chica. You are in my prayers!!

TTB- I am not sure why some are on the long or short protocols. I would assume that our RE's have done this so much that all the pretesting would say who would need which protocol. This is my best guess... LOL

Dancing- Good Luck at ER!!! I am eggcited for you!!

Blue- I watched the show... That is too cool!! I was like I know her (well sort of) LOL I agree with S08 they really danced around the true pain of IF, but at least there was some recognition.

Haj- We both have our appointments this Friday, just two days left! Hopefully we will be stimming soon!!!

Waiting- As for the meds. I am going to assume that the prior diagnosis, all the pretesting, costs, and specific RE has something to do with who is on what. Correct me if I am wrong ladies. But in my case I was going to go with Gonal because it was cheaper than the Follistim (My RE prefers Follistim) but I lucked up and was able to obtain the Follistim.

Michelle- I will be praying for AF to come!! Looks like anyday now...

Mobaby- LOL on the twin dreams. I too have been having crazy dreams. I had the craziest dream ever. I actually was cracking up in my sleep and woke up laughing. My hubby was standing over me like wtf... My embryo's were in the dishes, but the dishes were club scenes. There were lots of embies (females) but two were DIVA embryo's. They were standing there talking to each other like look at these fools. You get the picture. When the sperm enter the "club" they were racing to get to the diva embies, some were ghetto sperm, some were carrolton, some were jocks etc. But they were pushing and shoving, cussing, and fighting. Long story short two spermies entered the diva's and they started doing the snake (dance) and talking mess to the others left outside. I woke up at the snake dancing part. I laughed all day about that dream!

Mrs C- Again thanks for maintaining this growing board of wonderful ladies! We appreciate you!!! Also, don't worry about the timing with hubby... Everything will work out!!

To any ladies that I left out... I will catch you on the next round!! Feeling easy breezy today! Hope you all enjoy this wonderful Tuesday!

I wish it was 2 days but we still have 3 lol

 

[haj624]

Ok ladies, questiong. *WARNING* It might be dumb lol

I have my baseline on Friday. Are the looking to see how many follicles I have or am I not supposed to have them yet?

 

[michelle01]

Ok ladies, questiong. *WARNING* It might be dumb lol

I have my baseline on Friday. Are the looking to see how many follicles I have or am I not supposed to have them yet?

That is not a dumb question and seeing as I have been through one round of IVF, I cannot even remember Honestly I think it is to measure your lining and make sure all is good to start your stimming. I do think you have follicles that are smaller and maybe not many since the stimming will increase them, but gosh, you would think I would remember

I also had the craziest dream last night that I was pregnant! Seriously through everything I have been through these past few months I have not had any dreams like this before; it is crazy. I was dreaming they were taking me back to give me a c-section and the baby was very pre-mature, they didn't know I was pregnant and neither did I

 

[haj624]

Ok ladies, questiong. *WARNING* It might be dumb lol

I have my baseline on Friday. Are the looking to see how many follicles I have or am I not supposed to have them yet?

That is not a dumb question and seeing as I have been through one round of IVF, I cannot even remember Honestly I think it is to measure your lining and make sure all is good to start your stimming. I do think you have follicles that are smaller and maybe not many since the stimming will increase them, but gosh, you would think I would remember

I also had the craziest dream last night that I was pregnant! Seriously through everything I have been through these past few months I have not had any dreams like this before; it is crazy. I was dreaming they were taking me back to give me a c-section and the baby was very pre-mature, they didn't know I was pregnant and neither did I

They did the measurements of my lining already at my last appt. i was curious if there were even supposed to be any bc i didnt start stims.

Well i hope youre dream means you will be pregnant very soon. minus the pre-mature part

 

[daisy83]

Ok ladies, questiong. *WARNING* It might be dumb lol

I have my baseline on Friday. Are the looking to see how many follicles I have or am I not supposed to have them yet?

My first baseline scan is to check that my ovaries are "quiet" (down regulated). If all is quiet then stims can start. I don't ovulate so I'm sure mine will have cobwebs growing off them already!!!

Welcome drsquid! And thanks Mrs Bear for sharing your story, I think all mine will be IVF but they said they can change to ICSI if they foresee any problems.

Ali

 

[haj624]

Ok ladies, questiong. *WARNING* It might be dumb lol

I have my baseline on Friday. Are the looking to see how many follicles I have or am I not supposed to have them yet?

My first baseline scan is to check that my ovaries are "quiet" (down regulated). If all is quiet then stims can start. I don't ovulate so I'm sure mine will have cobwebs growing off them already!!!

Welcome drsquid! And thanks Mrs Bear for sharing your story, I think all mine will be IVF but they said they can change to ICSI if they foresee any problems.

Ali

ok sorry what exactly is down regulated? is that what the lupron does?
Cobwebs? lmfao
I dont ovulate either but i produce follies...they just dont do anything.

 

[michelle01]

Ok ladies, questiong. *WARNING* It might be dumb lol

I have my baseline on Friday. Are the looking to see how many follicles I have or am I not supposed to have them yet?

My first baseline scan is to check that my ovaries are "quiet" (down regulated). If all is quiet then stims can start. I don't ovulate so I'm sure mine will have cobwebs growing off them already!!!

Welcome drsquid! And thanks Mrs Bear for sharing your story, I think all mine will be IVF but they said they can change to ICSI if they foresee any problems.

Ali

ok sorry what exactly is down regulated? is that what the lupron does?
Cobwebs? lmfao
I dont ovulate either but i produce follies...they just dont do anything.

Yes, down regging means your "system" is shutting down and lupron is one medication that does that. I took lupron through during my first IVF. My RE told me that it basically will shut things down and make it quiet. I started with 10 units and when I started stimming, they reduced it to 5 units. I really never asked why I needed to continue with lupron; I just trusted them.

What stimming meds do they have you taking?

 

[haj624]

Ok ladies, questiong. *WARNING* It might be dumb lol

I have my baseline on Friday. Are the looking to see how many follicles I have or am I not supposed to have them yet?

My first baseline scan is to check that my ovaries are "quiet" (down regulated). If all is quiet then stims can start. I don't ovulate so I'm sure mine will have cobwebs growing off them already!!!

Welcome drsquid! And thanks Mrs Bear for sharing your story, I think all mine will be IVF but they said they can change to ICSI if they foresee any problems.

Ali

ok sorry what exactly is down regulated? is that what the lupron does?
Cobwebs? lmfao
I dont ovulate either but i produce follies...they just dont do anything.

Yes, down regging means your "system" is shutting down and lupron is one medication that does that. I took lupron through during my first IVF. My RE told me that it basically will shut things down and make it quiet. I started with 10 units and when I started stimming, they reduced it to 5 units. I really never asked why I needed to continue with lupron; I just trusted them.

What stimming meds do they have you taking?

Right now I'm on 20 units of Lupron and then when I start stims they knock it down to 10. Right now the have me just doing 150 of Gonal F. What were you on?

 

[michelle01]

Ok ladies, questiong. *WARNING* It might be dumb lol

I have my baseline on Friday. Are the looking to see how many follicles I have or am I not supposed to have them yet?

My first baseline scan is to check that my ovaries are "quiet" (down regulated). If all is quiet then stims can start. I don't ovulate so I'm sure mine will have cobwebs growing off them already!!!

Welcome drsquid! And thanks Mrs Bear for sharing your story, I think all mine will be IVF but they said they can change to ICSI if they foresee any problems.

Ali

ok sorry what exactly is down regulated? is that what the lupron does?
Cobwebs? lmfao
I dont ovulate either but i produce follies...they just dont do anything.

Yes, down regging means your "system" is shutting down and lupron is one medication that does that. I took lupron through during my first IVF. My RE told me that it basically will shut things down and make it quiet. I started with 10 units and when I started stimming, they reduced it to 5 units. I really never asked why I needed to continue with lupron; I just trusted them.

What stimming meds do they have you taking?

Right now I'm on 20 units of Lupron and then when I start stims they knock it down to 10. Right now the have me just doing 150 of Gonal F. What were you on?

I was on menopur & follistim, but I was slow responding and ended up stimming for 11 days. Towards the end I was doing injections of follistim in the morning and another injection in the evening. I am hoping when I can start my second round, they either change my meds or start me at a higher dosage so I respond quicker. I ended up getting 9 eggs and doing a 5 day transfer, but the quality I was told was OK on the day of transfer. I also was did 2 Hcg booster injections after my transfer.

 

[haj624]

Ok ladies, questiong. *WARNING* It might be dumb lol

I have my baseline on Friday. Are the looking to see how many follicles I have or am I not supposed to have them yet?

My first baseline scan is to check that my ovaries are "quiet" (down regulated). If all is quiet then stims can start. I don't ovulate so I'm sure mine will have cobwebs growing off them already!!!

Welcome drsquid! And thanks Mrs Bear for sharing your story, I think all mine will be IVF but they said they can change to ICSI if they foresee any problems.

Ali

ok sorry what exactly is down regulated? is that what the lupron does?
Cobwebs? lmfao
I dont ovulate either but i produce follies...they just dont do anything.

Yes, down regging means your "system" is shutting down and lupron is one medication that does that. I took lupron through during my first IVF. My RE told me that it basically will shut things down and make it quiet. I started with 10 units and when I started stimming, they reduced it to 5 units. I really never asked why I needed to continue with lupron; I just trusted them.

What stimming meds do they have you taking?

Right now I'm on 20 units of Lupron and then when I start stims they knock it down to 10. Right now the have me just doing 150 of Gonal F. What were you on?

I was on menopur & follistim, but I was slow responding and ended up stimming for 11 days. Towards the end I was doing injections of follistim in the morning and another injection in the evening. I am hoping when I can start my second round, they either change my meds or start me at a higher dosage so I respond quicker. I ended up getting 9 eggs and doing a 5 day transfer, but the quality I was told was OK on the day of transfer. I also was did 2 Hcg booster injections after my transfer.

I have menopur just in case they decide to use it. Do you have any fertility issues?