IVF with ICSI, right?

Question

Done our diagnostic testing. All my numbers are good, 10 follicles, hormone counts normal, etc.  But I'm 38. DH: 1% morphology, he had reverse vasectomy in September. Been TTC for 6 months.  Our consult with fertility doctor is this week.  I like to be prepared. From my research, I expect we'll be told IVF with ICSI is our best/only option and that the number of embryos to implant may be 2, based on my age. And that gender selection will not be an option.  And that we should go for the "shared risk" program where you pay a flat fee for up to 6 IVF cycles and get money back if no libe baby (we are at Shady Grove).  
Anyone have any other info or advice?

Answer

Almost no one does traditional ivf anymore. ICSI is the new norm unless you go to an outdated clinic. 1% morphology is only an issue if his sperm count is low. Gender selection is just pgs. At your age I would highly recommend it if you get enough embryos to test. I would consider the shared risk program for sure. At 27 with unexplained it took me 3 cycles.

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Only question is why no gender selection? I thought u get to choose if u want the testing done or not.

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Im 38 too icsi worked perfect for us the first pregnancy ended i a miscarriage at 8 weeks because my embryos were not very good quality and none of the became blastos, the second fresh cycle i only had 2 good quality embryos and the rest didnt make it. Now im 34 weeks with boy/girl twins .

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PGS at our age (I'm 36) isn't usually recommened if you have low DOR. I've researched the heck out of this. Our poor eggs take longer to develop normally anyways. With my issues I am just glad if I get some embryos to day 5. I don't care what the gender is.

Answer

@charlotte The cycles are like this: each  cycle is complete with egg retrieval.  From there (depending on how many embryos you get... let's say 3) you have to transfer every embryo before you cycle(retrieve more eggs) again.  So, if you transfer all 3 embryos with no live baby, you have completed 1 of the 6 cycles and you begin again with cycle #2.  If you have a live baby, your package and cycles are complete.  you can also choose to do testing on the embryos: PGS testing (that tests the embryos to see if they are chromosomally normal and nothing more) or PGD testing (tests the embryos for specific genetic diseases that can be passed down... i.e. cystic fibrosis).  And yes, ICSI is the new normal now with IVF.

Answer

Not saying this will happen, but let’s say you only get 3 mature eggs to fertilize - I’ve read ICSI can potentially be too hard on the eggs and put them at risk. There’s an ICSI video on fertilityIQ.com I recommend watching.

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Have you read 'It Starts with the Egg' and/or the blog 'agate's guide to learning from your failed ivf cycle'? 
I started IVF at 40 and after 2 failed treatment cycles our RE suggested we considered donor eggs.   I wanted to try one more time though and I was able to use the info in those sources to discuss different treatment options (switched to estrogen priming with ICSI) as well as to define a 90 day prep with supplements and acupuncture before my 3rd IVF.   The changes we made significantly improved my response to meds and my egg quality and we finally got our BFP plus have one embryo on ice. 
As for the number of cycles, I would ask your RE to see statistics for the clinic on how many women get pregnant on cycles 4, 5 or 6.  I was told we had less than a 20% chance doing IVF at 40 and so that would translate to 5 cycles but honestly, I don't think I could have handled going through another full cycle physically or emotionally.  For that reason, I'd say go through 1 cycle first to see how you respond to treatment before committing to a package with so many cycles.  Just my two cents though.

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I’m at Shady Grove too, what state are you in? Only reason I ask is because I’m Maryland and a couple other states there’s an IVF mandate

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we have just been put on the waiting list for IVF/ICSI . we still have the pre tests etc . So hope its ok if i follow your post just for any info at all . wish you all the luck with yours!

Answer

Thanks for all the info! We've decided to wait at least 1 more cycle but the more we know the better. Keep em coming!

IVF with ICSI, right?

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