No fertilised eggs!!

[SR90]

Monday we had our first ICSI cycle.

I have low Amh but not drastically. OH has very low sperm, rubbish motility etc etc! He was advised he may have to do surgical sperm retrieval on the day.

Long protocol- Buserelin to down reg, Gonal F stims. 15 good sized follicles. Saturday night Ovitrelle trigger and Monday collection. 13 eggs collected!

OH’s fresh sample was enough to use so they didn’t need to do surgical retrieval for him. (Good news!)

Tuesday- only 5 were mature enough and 0 fertilised!!!

Waiting for review meeting. Does anyone have any advice, things I should ask to try next? I’m already taking supplements (dhea, melatonin, q10) for egg quality.

Any suggestions welcome!

[DianeArnold Partner Nurse Fertility Network UK]

Hi SR. So sorry to hear this. Perhaps a karyotype check or sperm DNA fragmentation test, to check all is well with his sperm.. Hope you get some answers. Thinking of you. Diane

[SR90 in reply to DianeArnold]

Thank you! We did Karyotype already as the clinic required it before they would accept us (due to OH’s very poor count and quality etc) but all good. I did wonder if maybe we should look at dna fragmentation. My review is next week so I want to be full of things I can suggest.

[Ivfgotadream]

It sounds more like an issue with your eggs than his sperm ? Since you had 13 collected but only 5 fertilised - that’s a pretty big drop off. I’d be asking the clinic their opinion on your egg quality? How old are you? Did you do ICSI? X

[SR90 in reply to Ivfgotadream]

I had 5 mature but 0 fertilise. I’ve just turned 31 and yes we did icsi.

I can ask them to look into my egg quality, it just isn't something they have ever mentioned previously although I know it would be hard for them to tell before my first cycle.

[MiniS5]

I agree with ivfgotadream, sounds more egg quality related than sperm. And it was my understanding that even if sperm was slightly on the poorer side then as long as the egg is good quality it can ‘turn it around’. I would certainly ask / look into egg quality. Age can be a factor.. x

[SR90 in reply to MiniS5]

We have been ttc for 2 years so even then (age 29) it was obvious it was not going to happen. I will ask them to look into egg quality.

[Libsie3103]

I agree with Ivfgotadream as well sounds like it could be egg quality, did they say how many eggs were mature? If it was ICSI I would expect fertilisation to be a lot higher than that. Protocol can affect egg quality so it’s worth asking your Consultant about that and exploring other options. I’m so sorry it’s so tough - on our second cycle we had zero fertilisation with 19 eggs and it was super tough, it’s not the stage of the process that you expect it to fail. Hope you get some answers xx

[SR90 in reply to Libsie3103]

Yes 5 eggs were mature but 0 fertilised. We did do ICSI due to OHs sperm.

We did a long protocol but that was due to my ‘lower’ amh.

Do you know the reason you had 0 fertilisation too?

It definitely isn’t what you expect! I at least hoped to get to transfer or near day 5! Hopefully next weeks appointment can shed a little light.

[Libsie3103 in reply to SR90]

We never got any answers in fact the clinic were really dismissive to the point that we moved. They tried to blame it on sperm quality due to my husbands recent cancer diagnosis but that didn’t hold up as we used frozen sperm from the same batch in the next round. We asked them about the impact on egg quality and they refused to try a different protocol. We moved clinics, tried a different protocol and had a very different response. I think different protocols work for different people. Really hope you get some answers next week Hun & can make a plan to move forward xx

[Ivfgotadream in reply to SR90]

My low fertilisation (less than 30%) even with ICSI on short protocol was due to egg quality. I changed protocol to natural modified IVF so focussing only on a couple of follicles abs fertilisation increased to 100% (and I had twins a couple of months ago)

Sometimes lower AMH responds better to more milder approaches (short protocol or natural modified IVF) - then the body isn’t forced to work so hard to produce eggs it would never have done in the first place

[MiniS5 in reply to SR90]

You mention you have lower AMH. Low AMH and poor egg quality seem to be closely linked (or so I keep being told) if you haven’t made any life style changes already then I would do so (organic, no toxins/household cleaners, non toxic toiletries etc etc a healthy diet) and speak to your consultant about changing your medication maybe for your next round.. xx

[SR90 in reply to MiniS5]

My consultant told me my AMH was 10.8 at 30 so only ever so slightly below what it should be (not sure on the exact numbers but that’s what she said).

My lifestyle seems to be healthy anyway, I guess the only difference would be organic.

Thanks for the suggestions ladies, i will mention shorter protocol because I’d rather have 2 top notch embryos than absolutely nothing, especially when paying private.

[MiniS5 in reply to SR90]

Good luck SR90 xx

[Jjf86]

We had egg retrieval yesterday useing icsi they collected 11 eggs and got the phone call today that only 4 fertilised, this is are second cycle now we had 8 fertilised and none made it to blast on that , so really not getting Hope's up with these these 4, it's hard to take and it's hard to feel positive about anything, I'd just love to know what it feels like to have a blast

[SR90 in reply to Jjf86]

I guess even having half the amount fertilised this cycle still gives you a good chance of getting to blast stage. But I completely understand how you feel when it’s over before it has even started really.

I’ll keep everything crossed for you. Is there a reason you are doing icsi?

[Lenni222]

Hiya. I had complete failure to fertilise my last round of ICSI. Its devastating I know. I was advised to have an artificial oxcyte activation (AOA) this time round, Through my own research, the best way I can describe it is they run your eggs through a calcium bath before attempting the ICSI process. So far it seems to have worked for us, I'm booked in for my fresh transfer on weds. The process didn't cost any extra, you just pay as normal for the ICSI, might be worth mentioning to your clinic? Sending love x

[SR90 in reply to Lenni222]

Hey, thank you for your message. How many rounds of icsi have you had?

I have heard of AOA, I was thinking about asking about it. My consultant was very surprised it happened but she said as it was only our first round, it could have just been a bad batch of eggs but she has changed my stims and trigger timings for next time. If we have problems next round then I will definitely suggest it.

The lab did say the egg was really hard to strip during the icsi process so I’m hoping the different stims will lower the quantity but improve the quality 🤞.

I did think I’d have to pay extra for AOA though, are you funded? X

[Lenni222 in reply to SR90]

Our first round was normal IVF, had 3 fertilised but none made it to blastocyst, the next round we had the ICSI and that was the 0 fertilised, and then again this round which luckily seems to be going as well as it can. We have been private through all rounds. My stims were also changed this cycle to Gonal F.. previously used Menopur x

[SR90 in reply to Lenni222]

Ah okay, Well best of luck this time around. It sounds really positive so far 🤞. 3rd time lucky 😊.

We’re private too. I’m glad Gonal F worked for you, it did make me feel unwell in the last few days so I was glad to stop when I did. I hope Menopur is better. I’m on a 450 dose though.

[Lenni222 in reply to SR90]

I must admit, I did feel quite unwell this time on the Gonal f, alot more so than menopur, I was on 300. I did prefer having the injection pre filled though! Xx

[SR90 in reply to Lenni222]

I had heart palpitations which was a strange feeling. Ye I’m not looking forward to the mixing of the Menopur but at least it’s not my first round so I’m not worrying about the evil Buserelin as well! 🙈

X

[Lenni222 in reply to SR90]

Ooh what's Buserelin? Is that the trigger? Sounds awful whatever it is 😂 xx

[SR90 in reply to Lenni222]

I had Buserelin for down reg meds, did you do the long protocol?

It gave me the usual menopause symptoms, night sweats, headaches, dizziness etc. Was lovely 🙈🙄

[Lenni222 in reply to SR90]

No, I have always done short protocol... are there more benefits for long protocol? On our last round I did 3 extra days of injections and felt like my insides were going to fall out! Xx

[SR90 in reply to Lenni222]

I was just told because I have lower amh I should do long protocol, suppose to have better time for more eggs to develop which did happen, but the results weren’t the best so 🤞 for swapping meds.

Ah I’m so lucky I didn’t have to do that but I’m not sure I’ll be that lucky this time.

Hopefully this one works for you and you won’t have to worry about any future cycles. X

[Lenni222 in reply to SR90]

Thank you. Hope everything works out for you too. Keeping everything crossed xx

[Hidden]

I would wait for your consultation, egg quality being an issue may not necessarily mean you have an issue with your eggs in general. After my first round and having 16 mature eggs we only had 1 early blast and I have high AMH. I was told it was an egg quality issue which was caused by the protocol (I had assumed that egg quality issue meant my eggs were basically no good but that wasn't the case) . Changed protocol next round and saw a massive difference. Sometimes it takes a few tweaks to get the right stimulation tailored to you. Our case was also male factor amd we did ICSI. Hopefully your consultant will be able to give you some detailed answers xx

[SR90 in reply to Hidden]

Thank you, I have had my consultation now.

They are tweaking my protocol next time to see if it gives me better results.

We are male factor too but actually his sperm performed quite well on the day and it was the maturing and fertilising that proved to be a problem.

I have borderline low AMH but not by much and I am only 31 so I will try whatever I can for my eggs and hope it’s not a problem. My consultant was fair optimistic about it but I guess no one really knows.

Thank you for the reassurance, I’m hoping it was just a bad batch 🤞.

[Hidden in reply to SR90]

Same with us, husbands sperm was good on the day so I was gobsmacked when my eggs were blamed, our fertilisation was always a little under 50% too. Just have to have faith in your consultant. I have my 12 week scan tomorrow so the changes worked for us.Good luck with it, they are making changes for your next round which is great and shows that they can see where improvements can be made xx

[SR90 in reply to Hidden]

Congratulations! I’m glad it all worked out for you and enjoy tomorrow x

[strawberriesandcream]

Contrary to what other people are saying, when we had failed fertilisation they said it was due to sperm and not egg. But that was with ivf and not ICSI. We had ICSI 2nd time and that fixed it. Our embryologist chatted to us straight away to explain why they thought it happened so I hope you have support from your clinic. Really sorry to hear this happened to you. I felt terribly hurt so I hope you’re holding up ok xx good luck with your answers xxxx

[SR90 in reply to strawberriesandcream]

That’s interesting to know! I had my review last week and they weren’t worried either way, they said his sperm were much better on the day but I worry about dna fragmentation etc. But I guess it’s just cross one thing off at a time.

Did they say why they thought it was the sperm that led to ailed fertilisation? x

[strawberriesandcream in reply to SR90]

So in the review did they think it was just a bad batch? Have they suggested anything they can do differently last time? I know the success of ICSI fertilisation is also dependent upon the skill of the embryologist.

Yes, they said that the sperm were losing energy before they managed to break into the egg. We also produced the sample at home instead of at the clinic because of covid. I personally think that contributed as well although they won’t admit that xx

[SR90 in reply to strawberriesandcream]

Ye my consultant said it’s probably a bad batch of eggs and hopefully next time it’ll be fine, but they’ve changed my meds to hopefully help with egg quality just in case that is a factor. Bit hard to tell when I’ve only had one cycle. I always joke about getting an apprentice embryologist! It probably was the case for us 🤣! Next time they are changing my meds from Gonal F to Menopur and changing my trigger from 36hrs to 38hrs to give them slightly longer to mature.

I can completely understand that, I think if you’ve had to try and keep it at temperature and take it to the clinic it’s bound to not be the best quality! I guess they wouldn’t want to accept that but I’m definitely on your wave length with that.

[strawberriesandcream in reply to SR90]

Good luck for your next time! I went from 0% in cycle one, to 4/5 fertilising and then all 4 making it to day 5 in cycle 2. The clinic were incredibly shocked so don’t lose hope. The more cycles you have, the more they understand what treatment will be right for you. Good luck, I hope the change in protocol will do the trick for you🤞

[SR90 in reply to strawberriesandcream]

Wow what a great turn out! Thats definitely a positive story, thank you! I hope we’re that lucky.

It’s so nice to be aware of all the things that can go wrong, or even right! X