Massive drop off in fertilisation rate after higher dose stims, alternative trigger and lots of supplements

[Orangeflowers]

Hi all,

I had my egg collection yesterday, and 18 eggs were collected. I've just heard that only 3 fertilised (most likely 2 as one has a fractured zona and is leaking out). Most of the eggs were empty or fractured.

As context, I had 30 decent follicles showing on my 9 day scan with 3 or 4 smaller ones. As I was at risk of OHSS my trigger was changed from Gonasi to Busterline, which I believe is much less effective. The embryologist hinted that being over stimulated may have been a factor in the poor fertilisation as egg quality was poor, with lots of eggs fractured or empty. I was on max dose Merifert of 450. I stimmed for 9 days (having two days of Merifert left untaken, due to follicles showing on 9 day scan).

I did have a successful round in 2020 were 20 eggs were collected, 16 were mature, 14 fertilised and 3 blastocysts resulted. That round I was on 225 Merifert, increasing to 300.

I have been taking a huge number of supplements as recommended in It Starts with the Egg, including 400mg of ubiquinol a day. Also 4,000iu of vitamin D (due to a genetic variant and my levels still being a bit low even at that level of supplementation).

My questions are:

Has anybody else had such a much reduced fertilisation rate between cycles? Was any reason for this suggested?

Could the supplements be having an adverse effect?

Could this just be a bad fertilisation round? The embryologist suggested that each round varies.

Could the overstimulation be a factor in reducing egg quality? My consultant indicated this wouldn't be a factor and it was better to up the stims due to my age.

Could the change in trigger be a factor?

I'm not feeling too hopeful as on my successful cycle although 14 were fertilised only 3 made it to day 5/6. So if I only have 2 left in the game on day 1 things aren't looking great.

If anybody has any thoughts or experiences that would be appreciated.

I hope everyone is so doing ok and that luck is coming your way xx

[AuroraXen]

Hi Lovely. I completely understand you being disappointed, that is a big drop off 😔 30 good follicles and 18 eggs are amazing numbers, especially at 41 (I've never got anywhere near that 😂). But it does seem like something isn't working quite right. It IS definitely possible to get a bad round for no particular reason. I went from about 14 good sized follicles one round to 2 on my next. I panicked as the rubbish cycle was 18 months after the better one. But my next round was my best yet (not saying much but hey ho 😄). But alternatively it could be that you're being over stimulated and it's resulting in lower egg quality. Do you do ICSI? Is there a sperm issue? I'm really hoping the embryos you did get are super quality and make it to Day 5( or 3 if your clinic does that) xx

[Orangeflowers in reply to AuroraXen]

Hey thanks for sharing 😊 It's really good to know that cycles can vary. I was on max stims so it sounds like that could be a factor, though beforehand the consultant said it shouldn't affect quality. I got 3 on my first round and 2 still in the game for this round so hoping outcomes might be the same regardless. I've just turned 43 unfortunately! Poor egg quality no doubt is mainly down to my age now.All the best for you x

[Orangeflowers in reply to AuroraXen]

Re ICSI - both cycles were without it just standard IVF. First round 14 out if 20 fertilised. This time, only 3 out of 18 fertilised. I find that puzzeling. My partner has no major sperm issues but morphology 3%

[AuroraXen in reply to Orangeflowers]

Hmm I wonder if ICSI would help then. We did it, and my husband is the same, 3% morphology but better than average count and motility. Wow, your numbers are really amazing at 43!! You could do a bit of searching on here for past posts about different types of trigger (if you havent already). Amd maybe it's worth doing a consultation with a different clinic, which specialises in us older ladies, to see what theyd suggesr. But listen, hopefully you won't need to do anything as you might get there again with these 2 fertilised eggs! Xx

[Orangeflowers in reply to AuroraXen]

Fab thanks, good suggestions - I'll do a bit of a search on here and ask a consultant when I get to see one. ICSI is definitely something to think about x

[Toni_79]

I just wanted to wish you all the best, and I hope that the 2 eggs are doing well. That's disappointing for you with having such a high number of eggs, but I really hope it can still work out for you this time. 🙏 x