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Does ICSI increase risk of miscarriage?

6 fertility expert(s) answered this question

Answer from: Saghar Kasiri, Clinical Embryologist

Embryologist, Director of European Operations
Cryos International

That’s not what the data’s are showing that ICSI does not increase risk of miscarriage. Usually when it is performed they see is very much on the other side trying to improve the chances of fertilization and development of a healthy embryo where we, for example, have a low sperm count or motility or abnormal forms, selecting a good quality sperm that is motile, that’s alive, that looks morphologically normal (that means the head, the neck and the tail looks normal) increases the chance of having a good embryo developing and hopefully implanting as well.

Answer from: Andrew Thomson, FRCPath

Embryologist, Consultant Clinical Embryologist & Laboratory Manager
Centre for Reproduction and Gynaecology Wales (CRGW)

Does ICSI increase the risk of miscarriage? Not necessarily. What happens with ICSI compared to an IVF insemination which is where you just mix the sperm and the eggs together, there is a higher rate of what we call congenital abnormalities. What that means is if essentially to an extent birth defects but you have to remember, some people have to have ICSI possibly because they have their own genetic defects, so for example cystic fibrosis and so the rate of those genetic defects being detected, will always be higher with ICSI because of the clinical history of people who tend to use ICSI. In a person who’s using ICSI with a normal sperm parameters, I’m not sure what that difference in congenital abnormalities would be but certainly the risk of miscarriage, I’m not convinced would be higher with than compared to IVF. I think they’re pretty similar. It’s just that rate of congenital abnormalities which will be higher with ICSI.

Answer from: Alexia Chatziparasidou,  MSc, PMI-RMP

Embryologist, Consultant Clinical Embryologist, Director of Embryolab Academy, Co-Founder of Embryolab Fertility Clinic
Embryolab Fertility Clinic

I wouldn’t say the ICSI as a technique but mostly because ICSI involves patients with very severely affected sperm quality. So if the sperm quality is affected, then yes, the use of these severely affected spermatozoa may produce an increase risk of miscarriage rates.

Answer from: Yacoub Khalaf, Professor

Gynaecologist, Professor of Reproductive Medicine and Surgery at King’s College

Not increase the risk of miscarriage in the sense that when you look at the results for male factor infertility, the live births per cycle is comparable with if you are doing it for tubal blockage or doing it for unexplained infertility or doing it for ovulation factor. So it does not increase the risk of miscarriage at all.

Answer from: Alessandra Parrella

Embryologist, Andrologist, Embriologist
IVF-Life Group

ICSI does not increase the chance of miscarriage. There are different studies that show that there is no difference between ICSI and IVF in terms of pregnancy loss.

Answer from: George Koustas, DR

Embryologist, Director of Embryology and Quality Manager
Agora Clinic

ICSI does not increase the risk of miscarriage. On the other hand all the studies that have been performed out there when it comes to miscarriage and ICSI, it has to do with male factor that is involved in order for us to perform ICSI. If there is male patient with very very poor sperm and we have to perform ICSI, if the embryo development is poor or if the patient end up having miscarriage – mostly it has to do with genetic’s of the sperm that we use rather than the technique itself.

About this question:

How common is miscarriage after ICSI?

ICSI has been associated with an elevated risk for birth defects, chromosomal abnormalities, autism and intellectual disabilities compared to conventional IVF. As per now, it is not confirmed that indeed ICSI is the cause of defects and there is strong belief that may also be due to the effects of subfertility.

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