Zero fertilisation for the second time, should I have additional testing?

[SR90]

Hi all,

I wrote a post here back in February about having zero fertilisation and low maturity, the clinic thought with it being my first round etc that it could be a bad batch of eggs etc.

We went for our second round last week after using Menopur this time and it appeared to have done the trick, I had 9 eggs collected and 6 matured as they should.

However, for the second time when injecting the sperm they do absolutely nothing and don’t fertilise.

We are now at the end of our rounds (2 cycles, very quickly over and done with!) so we will need to pay again for further rounds. In the meantime, can anyone recommend any additional testing we should do to look into why this happens? The clinic have mentioned the egg activation but just wondering if there were any tests we should really look in to to actually find the reason. (I’ve had my amh tested which is borderline low, my partner has had karyotype and cystic fibrosis which are both normal).

Thank you x

[leo1980]

I am so so sorry to hear. This happened to me in one cycle and it really knocked our confidence!

Have you both had the karatyping? How old are you? Worth checking your thyroid levels. And perhaps try AOA?

[SR90 in reply to leo1980]

Thank you for your reply, it’s definitely a horrible feeling, I feel like I’ve thrown 2 cycles away but only actually done half the treatment because we didn’t even get past day 1 following EC.

My OH has had the karyotyping which came back fine, I haven’t.

I’m only 31 with very borderline Amh.

We are discussing AOA at the next review in a couple of weeks but just wasn’t sure what additional testing I should look into.

My thyroid levels always seem to come back ok at the doctors (however I am convinced something is t right as I have always struggled with my weight), but it’s getting them to listen when they just say ‘your bloods came back fine’.

[leo1980 in reply to SR90]

I understand. I still can’t get over my cycle with Total fertilisation failure. I think I got PTSD! Worth checking the thyroid with an endocrinologist. Mine was slightly high, fertility consultant just gave my thyroxine to bring it down but it dropped to low!

I went to an endocrinologist and he put me on the same medication but he added iron to my supplements. The 2 cycles since have produced normal embryos (good quality ones). And I am 40! So your chances should be better

How are you both on the diet and supplements side? ( I am just trouble shooting here)

[SR90 in reply to leo1980]

The poor clinic isn’t going to know what’s hit them at my review meeting 🤣! I’m going to be armed with lots of demands and info!Googling Endocrinologists as we speak!

Diet wise we are pretty good, we have a few treats and take aways etc but every day kind of food is home made none processed etc.

Supplements, I’m taking folic acid, coq10, melatonin, dhea, vit d. OH is taking Wellman conception and Vit D additional. The clinic advised us on these. They may advise something else at the review.

[soccerkt6]

Hi lovely, that's awful, I'm so sorry to hear this.

You should have your husband do a sperm DNA fragmentation test. There's some evidence that high fragmentation leads to lower fertilisation rates, so it's worth checking out before you proceed with another round. I also agree with leo that you should have your thyroid levels checked. Push for more than just TSH though (FT4, FT3, thyroid peroxidase antibody and thyroglobulin antibody) since you can have normal TSH levels and still have abnormal results on the other markers. good luck xx

[SR90 in reply to soccerkt6]

Thank you so much! I will definitely look into both of those. It would be such a relief to find something we can fix, the unknown is horrible x

[soccerkt6]

It absolutely is. The more I think about, the more annoyed I get that doctors even let women undergo IVF with only an "unexplained" diagnosis. Fingers crossed you get some answers with the tests! xx

[SR90 in reply to soccerkt6]

We initially needed treatment as my OH has a very low count and are lazy etc, that’s when they spotted my slightly low amh and reserve. But it seems to be fertilisation is the major issue.

[Marisa32 in reply to soccerkt6]

Agreeing with Soccerkt6 here. DNA fragmentation tests should have been done on your husband after the 1st fertilization failure if not prior to IVF. You want to rule out male issues, before you start dragging yourself through multiple cycles.

[SR90 in reply to Marisa32]

Thank you! I did ask the clinic and they said they didn’t think we needed it ‘yet’ but I’m definitely going to do it now.

[Marisa32 in reply to SR90]

I think these things really depend on a clinic. None of the 3 clinics I dealt with (3 different countries) would do IVF on women until male issues were investigated first. As those things are not invasive in nature unlike putting women through IVF. Breaks my heart seeing women go through multiple cycles on here - only to find out in the end there was severe male factor.

[SR90 in reply to Marisa32]

definitely! It feels like such a waste whether it’s funded or self funded because it’s physically and emotionally draining in itself.I’m thankful we spotted OH’s low count etc prior to starting any of this but I’m now 2 cycles in and none the wiser really.

[Ivfgotadream]

Sorry to hear this - I agree on the sperm dna fragmentation test. But it could also be an egg quality issue which is harder to test for - what sort of trigger did you do? Some people find double triggers helps with the ability of the egg to fertilise

[SR90 in reply to Ivfgotadream]

It was a single Ovitrelle trigger but extended to 38hrs.

[Ivfgotadream in reply to SR90]

Sometimes a single trigger isn’t enough for the eggs to reduce to the correct number of chromosomes so is definitely ask about that

[Rocco11]

Hi SR, I’m sorry to read this and understand how devastating it is to go through TFF once let alone twice. In my case it appeared to be down to egg quality even though we started this journey due to male factors (amh 6.4). The difference in my cycles where we had fertilisation was a double trigger. Our last cycle which was the most successful from a fertilisation perspective was a result of 3weeks testogel beforehand, proceive Max for 3 months, acupuncture and the double trigger.I hope you get some answers at the review meeting. Look after yourself x

[SR90 in reply to Rocco11]

Thank you.

My review isn’t for 2 weeks so I’ve got plenty of time to research your suggestions, thank you. Egg quality is so tricky!

[Lilly12255]

Which clinic are you with?

[SR90 in reply to Lilly12255]

It’s in the midlands, not sure we’re suppose to name the clinics specifically.