ICSI, morphology and birth defects?

Question

Hello! My husband has been diagnosed with low morphology and we will most likely be moving forward with IVF with ICSI. I have read, and my doctor has mentioned, the higher risk of birth defects associated with ICSI. I understand it’s not the procedure itself but more the cause of the infertility, which in our case is morphology. This of course has me worried. His sister has a child with severe intellectual disability and was born with a hole in her heart (she tells us there is an unknown cause to why this happened). I am just so concerned that there is a connection between the 2. Any experience with ICSI and morphology issues would be great! Thank you!!

Answer

We did PICSI: 
Physiological Intracytoplasmic Sperm Injection. PICSI is a method of selecting the best possible sperm for fertilisation before injection into the egg in the IVF protocol. Sperm are placed in the PICSI dish containing samples of hyaluronan (a naturally occurring biopolymer found in all human cells) hydrogel.
What PICSI does is select sperm according to how well they bind to the hyaluronan around an egg cell. Mature, biochemically competent sperm bind are then isolated by the embryologist and used for ICSI.
The selected sperm is essentially the same as one that would be successful in the natural reproductive process. The more mature a sperm cell, the more able it is to bind to hyaluronic acid, meaning that it is better suited to fertilising the egg.
 PICSI is highly recommended in these particular cases:
Previous failure or low fertilisation even after ICSI.
Low embryo quality or their failure to develop (not related to poor egg quality).
Repeated miscarriages.

Answer

I’ve never heard this and it doesn’t make sense to me, as ICSI is allowing for the best sperm to be selected. They DO monitor the heart more with IVF (not ICSI specific) and you get an extra ultrasound or echo to check for heart issues.

Answer

I talked to my doc about it today and she told us standard ivf have 0.5 percent chance and ivf icsi have 1.5% chance of defect.  So it's only a 1% difference which is not much . If you want more information on what we talked with doc about icsi just message me . I'll share chat

Answer

I’m not sure there is a link. The process of ICSI is to pick the best sperm. It’s a really important question and you should ask for their statistics and speak to the fertility clinic if anything it will give you peace of mind. The worry is always much worse. 
🤞

Answer

So ICSI was invented in Belgium, we live in Germany.. I guess I’m the odd one out because our German dr said there’s absolutely a risk of higher birth defects but it’s not a huge jump from the normal rate.. typically people doing icsi had to also undergo TESE and that sperm is not typically the best despite their best efforts.. because naturally the best sperm would be able to find its way to the egg (survival of the fittest) whereas with icsi they are selecting the sperm based on their best guess/and some science.. but the biggest risk we’ve been warned about is heart defects and hypospadias (when the urethra opening is not where it should be on the penis). Anyhow, I think with morphology issues icsi could help reduce risks since they can pick the best looking sperm I would certainly ask the clinic what can be done to reduce the risks.. maybe CoQ10 for both of you?

Answer

Our second round of IVF they did ICSI right away. When we'd spoken about it the only issues that my dr felt could come from this method (any concerns) were the chance it could damage the egg and a higher chance of an egg dividing into two (twins). We had a better fertilization rate, 2 fresh transferred/3 5days frozen....and expecting twins in late Aug. Both look normal this far. But that's all I have to bring to the table.

Answer

I specially asked my doctor at the clinic about this as my husband only has 2% morphology. My question was song the lines of the morphology being linked to the DNA that the sperm carries and is there risk associated with using his sperm. She said there was no risk & his sample was great for ICSI.

Answer

Following.

Answer

Do PGS and transfer only normal embryos

Answer

I’m not sure that’s true. We did ICSI and never heard of anything like that. If you have that fear do the PGS testing, we did as well and knowing they only transfer perfectly normal embryos is a huge relief.

ICSI, morphology and birth defects?

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