Advice for low fertilisation rates?

[Jezzabelle]

Update: our little embryo caught up quite a bit and was in the early stages of forming a blastocyst by day 5 so the embryologist was more than happy to do the transfer! Now in the dreaded tww 🤞🤞 💜

We are doing our 3rd round of IVF and out of 6 eggs collected, 4 were mature but only 1 fertilised. Day 3 update today was not looking good as our only embryo was only 4 cells and looking quite fragmented. Our first round we had 3 /6 fertilise, 2 transferred but BFN. Our second round 4/6 eggs were immature and the other 2 fertilised abnormally. I’m booked in for transfer on Tuesday but not holding out much hope.

Has anyone else experienced low fertilisation rates and if so what did you do to improve things, if anything? Xx

[Jezzabelle]

I should add, we did ICSI on round 2, but reverted to conventional IVF for round 3

[Orla9298]

Not relating to fertilisation, but could you have a double dose trigger to help with egg maturation, to give you more to try and fertilise?

[Jezzabelle in reply to Orla9298]

Thanks Orla9298! We changed trigger this time from Ovitrelle to 10,000 Gonasi, but is definitely something I will discuss with the consultant xx

[Orla9298 in reply to Jezzabelle]

Oh I think 10000 gonasi is a good dose of trigger, it’s odd that you have a few immature eggs so maybe something to push them for answers on this as it would have been great to have them all mature!

What have your follicle sizes been at when you’ve triggered? I think anything around 14mm should be capable of a mature egg.

Sometimes when clinics don’t do collections on a Saturday or Sunday the clinic has to make the decision whether to trigger you a bit early for a Friday collection, or keep cooking you for a Monday collection - it’s crazy!

[Jezzabelle in reply to Orla9298]

I had 6 follicles that were between 14 and 22, so from my chart it looks as though they collected from the biggest 6 and the other 4 follicles were empty (I’m guessing!). I’ve got low AMH so never have particularly high numbers and this is possibly affecting the maturity of the eggs 🤷🏻‍♀️ We did egg collection on Thursday, which was a day later than I thought it would be.

Going to arrange for my husband and to have a dna fragmentation test and another SA as he hasn’t had a SA for 12 months.

Wondering whether it is worth trying short protocol or moving straight to donor embryos. Xx

[Orla9298 in reply to Jezzabelle]

I also have low amh and never got more than 6 eggs - I did 5 rounds and got 4,2,3,6 and 3 eggs in those rounds but all were mature. Mine were all short protocol, and the last 3 retrieval’s were natural modified ivf and I got better quality embryos than the first two rounds on high doses - maybe have a look at natural modified ivf?

Definitely worth looking at SA and dna fragmentation test though too, as you need to know that the sperm is ok before you think about donor eggs I guess!x

[Jezzabelle in reply to Orla9298]

That’s really helpful - thank you so much! I’ve been toying with doing short protocol / natural modified IVF so think this might be what we do for the 4th round. Xx

[Orla9298 in reply to Jezzabelle]

Often you can get a package of 3 natural modified rounds for good value, I’d say it’s worth it xx

[MofM in reply to Orla9298]

I second Orla's suggestion. My first cycle had a very poor maturation rate, but second (and third cycle) I used a double trigger and it was much better! Recently, the clinic mentioned to me also calcium ionophore, but I am not sure what it is and whether it makes sense in my case.

[Ivfgotadream]

I changed protocol to natural modified IVF with ICSI and fertilisation went from less than 30% to 100% - but it’s a gamble as only going to get a few eggs each time as it’s very low dose drugs

[Orla9298 in reply to Ivfgotadream]

I’m a big believer in natural modified too! But I got more eggs with natural modified too, which is crazy!

450iu: 2 eggs

450iu: 4 eggs

75iu: 3 eggs

150iu: 6 eggs

225iu: 3 eggs

[Marisa32]

For us low AMHers, less is more when it comes to stims. So I agree with natural modified as being a better option. Too much stimming just seems to fry our eggs. 😬

[Jezzabelle]

Thanks everyone! This is really helpful and is giving me some hope in being able to try something else and not give up. I know we aren’t entirely out yet this round but we need to be realistic given hot poor our only embryo was looking today, and focusing on what we can do next is a massive help! Xxx

[Lilly12255]

My advice is to change clinic. Labs handling have large influence on fertilisation outcomes