Case Studies
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Case Study ICSI
Case Study ICSI
Rachel and Barry had been together for 18 months. Barry was 44 years of age and had two children from his first marriage. Thinking his family was complete, Barry had a vasectomy nine years ago. Rachel was 32 years old and healthy. She had never been pregnant. The couple came to SEFC to discuss whether they could have a child together. As Barry had children, the couple were not eligible for NHS treatment.
At the consultation, two options were discussed with the couple. It was possible that they could elect to have treatment using donated sperm. However, the couple were keen to have a child together, if at all possible using Barry’s sperm. Therefore, Barry was recommended to undergo a sperm retrieval procedure. It was explained that the procedure was quite straightforward, being carried out as a day case under sedation. A fine needle would be inserted into the epididymis to aspirate sperm. This would then be prepared and stored for future fertility treatment. The aim of the procedure was to collect sufficient sperm that Barry need never undergo the procedure again. Certainly the procedure is much less complicated than an attempted reversal of vasectomy.
The next phase of treatment would involve Rachel undergoing a course of IVF with ovarian stimulation and egg collection. The egg collection procedure would be carried out under sedation as a day case. Prior to this Rachel would undergo a course of ovarian stimulation with injected medication.
The numbers of sperm collected following sperm retrieval would be quite small. In addition Barry would have antisperm antibodies as a result of the previous vasectomy. In order to achieve fertilisation the couple were recommended ICSI (intracytoplasmic sperm injection), whereby single sperm would be injected into the eggs. Hopefully fertilisation would be achieved and up to two embryos could be transferred to the uterus. For Rachel the pregnancy rate would be in the order of 30% or more at embryo transfer with a multiple pregnancy rate in the order of 20%.
The couple were offered counselling to discuss any anxieties they may have about treatment. The couple were also advised to arrange for HIV and Hepatitis B and C screening before any surgical procedures were carried out.
Barry’s subsequent sperm retrieval was successful. The samples prepared well and sufficient sperm were collected for up to four attempts at treatment for Rachel. Rachel then proceeded to her treatment and eight eggs were collected from the ovaries. Five of the eggs fertilised normally and two good embryos were then transferred to the uterus three days later.
Rachel and Barry had a positive pregnancy test after an anxious two week wait and the pregnancy scan at seven weeks gestation confirmed a single pregnancy. The couple arranged antenatal booking with their family doctor. They were asked to contact the clinic with the outcome of the pregnancy.
Cost:
Rachel and Barry paid £160 for the initial consultation. The couple were both screened for HIV and Hepatitis B and C (total £200). Barry’s sperm retrieval cost £1,500, including storage of the samples for one year. Rachel underwent a course of IVF, combined with ICSI. The basic IVF price was £3000. The ICSI procedure cost an additional £1000. Rachel and Barry paid £75 for the HFEA licence fee, which all couples have to pay for an IVF cycle. The total cost of medication for the treatment cycle was £750. The total cost of Rachel and Barry’s treatment was approximately £5,750. A detailed and up to date price list is available from the clinic. Prices quoted are correct at the time of publish.
Comment:
Rachel and Barry could have had treatment with donated sperm at SEFC. However, like many couples, they preferred to have a child together if at all possible. Sperm retrieval is a relatively new procedure which allows the collection of small numbers of sperm from the epididymis of men who have previously had vasectomy. It is a very straightforward procedure and certainly less complicated than a reversal of vasectomy. As Rachel was healthy her treatment was uncomplicated. The ICSI procedure is also helpful in overcoming any problems with antisperm antibodies.
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