Round 2 heartbreaking egg collection...

[Zoe222]

Hi IVF warriors

I felt I should share my heartache and ask for advice as only you strong ladies can understand.

Following a cancelled round 1 I went ahead with an NHS round 2. Two prostap injections and twelve days of maximum allowed dose mixed stims later I produced 3 follicles. I guess you could call that a result with an AMH of 0.6 at 38. I hoped for the best - you only need one good egg right? I triggered with 250 Ovitrelle and went for egg collection. I was waiting to be called in worried not to ovulate prematurely, my left ovary only had one follicle and I felt some pain there while waiting. This was 36 hours post-trigger.

I was awake throughout the procedure and couldn't wait to know what was the outcome. The doctor comes to see me in recovery - ''I am sorry we didn't collect any eggs, the two follicles on the right were empty and the one on the left shrank''.

''What do you mean shrank? Did I ovulate early?'' - ''That could be the reason we are not sure. DE is your next option''.

I burst into tears. Devastated, heartbroken no words to describe the heartache. I am not ready to give up on my own eggs. I took DHEA, Ubiquinol, prenatal vitamins, probiotic the lot... and this was the result - no eggs.

Has this happened to anyone? Can anyone help with what could have gone wrong? Or am I just not producing viable eggs any longer and should really give up? They asked me to book a review once I had a bleed so it will be a wait to speak to the hospital.

Any advice will be much appreciated. Thank you. X

[Mazzath1]

Hey, I'm so sorry to read this. It's absolutely heartbreaking. I was in a very similar situation. My amh was higher at 4.3. But I was just throwing money away I did all the recommended supplements, accupunture, chiense herbs. . I just new my time with my own eggs were coming to a end!!! I had to greive. My only option was d.e. at first I thought absolutely no way!!! After 7 years of infertility. I did start too think about it. Was it actually that bad. Would make become a mum. Now I'm mum too boy and girl. Twins born last year. I don't regret at it all. The love I havd for them would be no different. They are part of me. There my absolute world. But evey situation and person is different. Still can work for you. I wish you lots of luck. Xxx

[Zoe222 in reply to Mazzath1]

Thank you and congrats on your twins. My partner is totally against the DE option, I am not sure I am ready to face it yet but I am not excluding it. I think I need time to grieve as you say. xx

[DOCIreland]

Really sorry to hear this 😢 at the end of the day only you can decided what to do next. Wishing you lots of luck in what ever you decide. Xx

[Zoe222 in reply to DOCIreland]

Thank you x.

[Orla9298]

Hey lovely, I had this with my first round, amh of 2.7 ish, I had about 7-10 follicles looking like they would be able to be collected from. Egg collection delayed, then they only got 2 eggs, I had no other follicles. I also had pain before the collection and think I ovulated. They wouldn’t admit it.

We repeated it and we collected 4 eggs and the embryo quality was so so poor. Both rounds were max dose stims.

I then moved to a clinic where they do low dose stims, to focus on better quality eggs and embryos. I did 75iu, 150iu and 225iu, rather than 450iu on my nhs rounds. In the 150iu round I got 6 eggs and 5 blasts!

I have ultimately ended up doing two donor egg rounds, and now have my precious baby girl, and I honestly wouldn’t change a tiny bit of our journey, as she is so perfect, if it had been any other way, she wouldn’t be her!

BUT, I wouldn’t have been ready for donor eggs if I hadn’t tried the lower dose package of 3 rounds. I think I was just unlucky, my embryos from my own eggs in that round weren’t great, they weren’t terrible, but average to poor.

I’d say do some research into “natural modified ivf” and consider doing 3 banking rounds.

The nhs doesn’t really support lower dose drugs or natural modified ivf yet, which is a shame as high doses of drugs aren’t always right for us low amh ladies.

Do you know what your antral follicle count was at any scans you had during your investigations or before your stims?xx

I actually had much much better results with lower doses of drugs

[singleswimmer in reply to Orla9298]

I think this suggestion sounds really sensible. I’ve had a few rounds of stims (social freezing and IVF) and the worst one was on the highest dose, paradoxically - I lost follicles (there were 5 of 6 but they only saw 2 at egg collection) and I was aware something was wrong, even documented an LH surge on ovulation sticks during the cycle.. but the clinic didn’t listen to me and were then surprised by the loss of follicles (I wasn’t surprised!). It does sound like you ovulated. After my bad round I read up on lower dose + other modified protocols in the case of low ovarian reserve and think there is a strong case for it.

I think the doctor’s response is inappropriate and reflects a lack of experience and/or thorough intellectual engagement with the ins and outs of IVF. Sadly I don’t think this is uncommon at all.. I don’t understand why they apply such a blanket approach to patients when to my mind individualised protocols make much more sense. It’s really baffling and upsetting.

I think you should see this failed round as an experiment and concentrate on researching next steps. As Orla9298 says, the process matters and there’s value to trying different approaches - it also gives you time to adjust to the idea of a donor egg as a back up.

Sorry you had to go through this traumatic experience - but hang in there!!

[Zoe222 in reply to singleswimmer]

Hi singleswimmer - Thanks for your response and for sharing your story. Reading yours and Orla's messages makes me feel that I should probably try again and that I must have been right about ovulating early.

I am sorry you've had a similar experience too! It's thought to end up with no eggs after weeks of injecting hormones and a rollercoaster of emotions.

I think you are spot on re the doctor that did the procedure. Although he is experienced, he is not engaged at all. I felt like I am just a number for him. The same doctor investigated me for recurrent miscarriage and did a uterine septum surgery on me. I had to read heaps of clinical trials and medical journals and direct him every step of the way. He knew what to do just wouldn't recommend anything unless I asked for it. It was exhausting. Apparently, that septum surgery was done very well - I've been told by other doctors that it looks ''really good'' down there.

Thanks so much for the encouragement, it means a lot and I really need it right now! I've seen on your profile that you are on your TWW. I am keeping everything crossed for you! xxx

[singleswimmer in reply to Zoe222]

You’re v welcome - I totally get what you mean by the exhaustion of having to be in the driving seat, it effing sucks!! This forum has been really helpful wellspring of information for me - keep us posted and I will keep an eye out for any relevant studies 💪🏻

[Zoe222 in reply to singleswimmer]

Thank you! I will keep you posted. x

[Zoe222 in reply to Orla9298]

Hey Orla, thanks so much for sharing your story and congrats on your little girl! It's reassuring to know that my gut feeling re ovulating early is probably right and I am not the only one! Glad that your story has a happy ending it sounds like you've been through a lot to get to where you are now!

I've already looked into natural IVF as a plan B and was thinking to book the well-known clinic - I am based in London. I am worried that the chances of a natural IVF working are very slim but I like the sound of not having any drugs (or having little). Right now I am feeling sorry for myself and my bruised swollen belly so the idea sounds appealing but still confused..

I asked the NHS hospital what my AFC is but getting exact info from them is challenging. The baseline scan this round only showed one small follicle in the left ovary. They told me this was expected following the two monthly prostap injections I've had.

The first round was cancelled following four weeks of Buserline injections. I didn't respond to the drug and at the last scan, the hospital said I have ''a few'' follicles in both ovaries and a dominant follicle in one. Whatever that means.

Thanks for the advice very much appreciated! xx

[ebonyebene in reply to Orla9298]

Thanks for sharing this, I had a similar outcome with NHS rounds, both of which failed. Planing on private treatment abroad now as I've lost faith in the NHS and treatment here is so expensive.

[FrancyItaly]

I’m so so sorry to read this, it’s so unfair 💕

[Zoe222 in reply to FrancyItaly]

Thank you.x

[Babytocome]

Hi, What Orla9298 is what I would suggest to check.

Have a look into “natural / modified ivf” those clinics are informed women with very low AMH , they concentrate on quality and not quantity.

Also they are cheaper than too.

[Zoe222 in reply to Babytocome]

Thanks for your response and suggestion Sonisonix. I've looked into the natural IVF option. It's good to know that's what people think and thanks for the encouragement! X

[Skittles11]

Hi Zoe. I'm so sorry to learn what happened at your egg collection. This exact same thing happened to me about 10 months ago. I was expecting 2 or 3 eggs from 3 or so follicles. When I came round after the procedure and sedation, I was heartbroken to learn that no eggs had been collected. It is an incredible feeling of hopelessness and overwhelming anguish that words cannot describe.

The doctors offered various explanations for why this may have occurred and these reasons included "the batch effect" which means that the eggs being stimulated in that cycle were unexpectedly of a lower quality. I was told other reasons could be my personal response to Gonal-F (which I was really slow to respond to) and/or the long protocol.

My clinic didn't mention donor eggs at this stage. They had some ideas about other things to try. These things were changing from long to short protocol, changing from Gonal F to Menopur, letting follicles grow to 22-24 mm before triggering and increasing the timing of the trigger shot. My response was much better. Chat to your clinic about adjustments to your protocol when you have your review. Get a second opinion if they are set on doner eggs if this is not what you want.

The other thing I would say is I cannot understand why you must wait for your bleed to book a review. You have had an ordeal and I think should be able to book in for the next available review slot, waiting for a bleed doesn't serve a purpose in my opinion, just prolonges your wait.

Finally you really aren't alone. As I say this happened to me and I felt broken. It was 10 months ago and we haven't fallen pregnant yet despite a few goes at IVF but we are still trying and I have done some healing since since that awful day. You will heal as well xx

[Zoe222 in reply to Skittles11]

Hi Skittles - Thank you for sharing your experience with me, it does help to know I am not alone. I am so sorry that you've gone through the same trauma! It truly is heartbreaking to have no eggs at the end of a round.

Thanks for letting me know the reasons they gave you for not having any eggs. It made me think that I shouldn't give up on my own eggs just yet. If I am to continue with a stimulated cycle, I feel strongly about not being on a long protocol anymore. This round was torture - six weeks of prep I was losing patience.

I can't understand why I need to wait for a bleed either, it must be an NHS protocol of some sort - probably to make sure they didn't put me in pre-mature menopause as it can happen when taking prostap and having a very low AMH as I do.

I have to find another clinic, don't have any more NHS rounds and there must be better private clinics out there.

Thank you for the encouragement and kind words it means a lot! I hope you get your happy ending soon. You've been through a lot and we all deserve to have that rainbow baby! Xxx

[Babyhope8]

I’m sorry to hear this . From a fellow low amh , I can tell every cycle had been different. My second was disappointing currently I’m on my third ivf now , I somehow feel that with low amh I’m not only producing low counts but low quality as well. I’m making up my mind for a donor if it doesn’t work . All my cycles hv been paid so it’s important to keep a check at some point. My suggestion for you try another cycle or two private if required before u go on donor . I know acceptance to not use own eggs is not easy

[Zoe222 in reply to Babyhope8]

Thank you for the encouragement Babyhope! I am not a quitter normally but equally don't want to end up throwing money. It is a very tough decision to make re DE. I hope that this round will be a success for you! Fingers crossed! xxx

[Kittielou]

I'm so sorry to hear your news. No matter how hard you try to prepare yourself for the disappointment, it's still dreadful. I'm grieving after my 4th cycle and 3rd unsuccessful embryo transfer. It was suggested I go with ED after my 3nd cycle resulted in no embryos (even with a decent AMH for 40) I was really angry and not ready to even think about it at that point. I'm happy that I've tried two more cycles and I'm now in a place where I think ED can only be better than a 5th failed attempt for me. If you're not ready to consider another path then don't. Listen to what your body and mind are telling you. If you get to a point where ED or another option is the right way to go you'll need to be fully invested in it and that will only happen if you choose it. Fingers crossed to you and all the other responders, we don't deserve to be going through this xxx

[Zoe222 in reply to Kittielou]

Thanks for sharing your experience and your advice Kittielou. This whole process is very tough let alone having to think about DE. I am so sorry that you've been through 4 rounds with no luck. It is heartbreaking.

I hope your next round works! I've always been a believer that if you really want something you should do the impossible and get it in the end. We all deserve to hold that baby at the end of this long struggle. xxx

[Zoe222]

Hi Diamond thanks for your response and I am so sorry that you've had similar experience! It's very hard to deal with this especially after so many days on stims.

How did it go with the bloods? Did they confirm you've ovulated? I hope you have viable eggs from this round. Fingers crossed!

I know what you mean about knowing what happened so that you can process it and continue. I don't think I will be told what happened but will wait for the follow-up.

Xxx

[Running79]

Hi

It’s a difficult one really

I started IVF at 37/38 had an AMH of about 21, had lots of follicles, 21 eggs collected 19 mature and fertilised we were left with 2 5 day blasts, one BFP ending in MC the other failed to implant

Round 2 I was 40/41 - AMH of about 19, again lots of follicles, 12 eggs collected 10 mature and fertilised, 3 made it to day 5, the one put back failed and the other two were PGTA tested and found to be chromosomally abnormal- this round I took the majority of vitamins you did except dhea

Round 3, decided to use my 30 yr old sisters eggs, 3 made it to day 5 blast, first one put back we are now 27 nearly 28 weeks pregnant

AMH is an indicator of what your reserve looks like, unfortunately it does not tell you the quality of your eggs - past the age of 35 our eggs are in decline, so all you can do is wait for your next appointment and discuss it with the consultant

[Zoe222 in reply to Running79]

Thanks for your response Running and for sharing your story. Congrats on your pregnancy! I hope the delivery goes all well for you.

I've been pregnant 3 times naturally between the ages of 34 and 36 and miscarried 3 times. This makes me think that my own eggs were never good enough even when I was younger. I have endometriosis and had several surgeries that are known to alter the egg reserve. I went through so much to get to IVF including removing my fallopian tubes in preparation for it. I spent days reading clinical trials and medical journals trying to understand what could have caused the miscarriages. I had so many issues, but it could have just been the egg quality. It's so hard to accept that I may need a DE after all the effort and everything I put my body through.

I doubt I will get an answer at that appointment but remains to be seen. X

[Marisa32]

As a poor responder with low AMH, I would recommend natural or mild IVF. Max stims won't do anything for you other than fry your eggs. If possible do multiple cycles and bank embryos. I was about to do DE as well but got pregnant naturally at 42 after trying for over 12 cycles.

[Zoe222]

Thanks for your response, Marisa. Congrats on your pregnancy! It's great to hear that you've had a happy ending to your struggle, you've been through a lot! I am looking into multi-cycle packages. Fingers crossed that it works out.