My fertility doctor recommends ICSI when doing the genetic testing (PGT). This is not covered by my insurance so it adds another $1,350 to our out of pocket expenses. I have read a number of articles/published literature stating that there is no statistical significance in outcomes when PGT is done with ICSI or not. Has anyone decided not to do ICSI when doing PGT? Thanks in advance!

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Our first cycle we did not do ICSI and none of our eggs fertilized. Round 2 & 3 we did and ended up with 3 and 2 blasts,.

For most people ICSI helps if you don't have good fertilization or blast results. They pick the best looking sperm to force fertilization.

For a small group of people, it destroys the eggs and gives the opposite results.

Our Dr made it seem optional and then I found out ~80% of people who do IVF use ICSI and I will always be upset we did not use it our first round.

If if it's your first time you could ask them to do half ICSI hald natural and see what works better for you.

Best of Luck!

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My office requires ICSI, they won’t do it any other way. Unfortunately my insurance doesn’t cover, but the cost was (shockingly) only $500. Pennies in this process :)

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Additional details: unexplained infertility, sperm was normal, both early 30s. Ended up with 6 PGT normal embryos

We did half icsi and half natural for our last cycle. The euploid we got was from our natural fertilization.

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Thank you for sharing! The research really doesn’t support us doing ICSI. My only fear is not having success with this round and then blaming myself for not doing it but I feel fairly confident in our decision.

My fertility clinic STRONGLY recommends doing ICSI if doing PGT testing. Here is a warning we were given about not doing ICSI with PGT testing. We are doing ICSI with PGT even though my husband’s sperm tests came back great. We have unexplained female infertility.

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My clinic also strongly recommends ICSI and my doctor referenced the ASRM committee opinion on ICSI for non-male factor indications, she said they “strongly recommend” ICSI but when I actually read the guidelines that was not the case at all. The study that references DNA contamination was from 2005 but ASRM stated
that with the newer genetic testing available it is less of a concern. Generally I would take the doctor’s recommendation but it does not seem to be supported by literature. I can’t help but think it is a source of revenue for the clinic.

For us, our diagnosis was unexplained infertility, so our doctor recommended ICSI to overcome any sperm issues that we may or may not have had. My insurance covered ICSI.

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How much of ICSI success depends on the skill level of the embryologist? Our doctor suggested 50/50 and we concluded this might be a safe bet to spread the odds (natural vs. skill of human intervention)

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I didn’t even know you could do testing without ICSI, so there’s that.

Nope, just ICSI. We are going to do the genetic testing so we have to freeze the embryos but it is more about how the embryos are created in the first place.

My clinic only does PGT-A testing if ICSI is selected. ICSI doesn't improve live birth rate, but it does improve fertilized rate. Almost 80% of patients choose ICSI in the clinic that I went to, whether it's covered by insurance or not. It costs $600 if out of pocket. Check with your clinic to see if they offer discounts if paying out of pocket

Yah it is totally a personal choice. I was expecting to do it since my doctor recommended it but after reading all of these studies I couldn’t figure out why it is so common in the IVF process.

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