BONUS 277: ICSI without Male Factor

September 18, 2020

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Today’s bonus episode guest is Dr. Allison Rodgers. She is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and has been practicing medicine since 2004. Dr. Rodgers currently practices at the Fertility Centers of Illinois. Her personal experiences with both secondary infertility and pregnancy loss have given her a unique insight into reproductive medicine in order to help you beat infertility.

Episode Sponsor:

Infertility Coaching with Heather Huhman

Dr. Rodgers begins by answering six listener questions. The full questions are read on the air, but here are brief summaries:

  • Brianna has normal hormone levels except for low progesterone and high AMH. She asks what the terms “pre-receptive” and “post-receptive” mean, and how those would be tested.
  • Kat has been trying to conceive for a year and has an unexplained infertility diagnosis. The doctor recommends IVF with ICSI with a high dose of stim meds but has not mentioned IUI. She asks about the wisdom of this treatment plan.
  • Jackie has had two miscarriages in the past six months and has a lean PCOS diagnosis. Her RE recommends Letrozole, but Jackie asks if this is right for her and if it might improve egg quality, which she suspects might be an issue.
  • Tess is a 40-year-old single woman in the Netherlands. After six unsuccessful IUIs, her OB wants to try three more IUI cycles with stims before moving to IVF. Tess asks if this is the best approach to help her get and stay pregnant.
  • Sandra has a history of uterine cancer. Her last egg retrieval yielded only one egg because most of her follicles were empty. She asks about her mediations and treatment plan.
  • Mandy has had a few failed IVF cycles with two failed Day-3 transfers. She asks how to know if her problem is getting the embryos to the blastocyst stage or implantation and if an ERA test might be helpful.

Dr. Rodgers and Heather continue the episode by discussing using ICSI without a male factor infertility diagnosis:

  • ICSI
    • What is it and can you describe the process?
    • Why might an egg not fertilize or develop properly afterward?
    • Are there any risks? What are the pros and cons?
    • How does it compare to conventional insemination and PICSI?
  • ASRM published a guideline about using ICSI without a male factor infertility diagnosis. What information was used to develop this guideline?
    • Unexplained infertility
    • Poor-quality eggs
    • Low egg yield
    • Advanced maternal age
    • Prior failed fertilization with conventional insemination
    • Routine use
    • PGT
    • After IVM
    • Frozen eggs
    • Other non-male factor situations
  • Overall, what are the conclusions about using ICSI without a male factor diagnosis?
  • What research has been done in this area recently, and what questions remain unanswered?
  • Is there anything else you’d like to add?
  • What words of hope would you offer to infertility warriors who are considering using ICSI even though they don’t have male factor?

Have a question you want Dr. Rodgers to answer next time she’s on? Click here.

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