Change in cycle protocol any advise?

[Applepie7]

Good morning ladies!

I hope everyone is well. So I thought I was starting my next IVF cycle on long protocol next month. Given this will be my 6th cycle I really want to give it my best shot. I do have a few embroys in the freezer but due to my age my consultant suggested I harvest more embroys whilst I can as he feels my window will close shortly. Each cycle I produce lots of folicals they retrieve around 19 eggs at collections but I only ever manage to get two embroys. I asked my consultant what I can do differently this time round and he has suggested I do ICSI even though there is no sperm issue , he thinks we should do ICSI and add Calcium Inophore to activate the eggs. He has also suggested that I add Growth Hormone and start the contraceptive pill from day 14 of my cycle. I wasnt expecting a big change like this and most of what he said went over my head because a) I was excited because there is something new I can do and it gave me hope and then b) I got anxious due to the financial costs and thinking what if this doesnt work again! So I just wanted to ask if anyone has done the above and what I should expect? Were you successful? Side effects? Anything at all would be great. Thank you so much and sorry for the long essay

[Orangeflowers]

Hello, no advice I'm afraid, but following as I'm getting similar results. Lots of follicles, few blasts. Not heard of activating eggs before, is that a big add on cost? Good luck! X

[Rol81]

We don’t have sperm issue either but they always do isci. Maybe because I don’t get many eggs. If it’s something you haven’t tried before maybe it’s just worth giving a go xx

[MrsOrangejuice]

Don't know about the other suggestions but on ICSI we did that on the first round because on the day my OH's sample wasn't great, but fertilization and number of blasts still wasn't brilliant. The next round we opted for it again even though his results were back to good, just in case. We were warned that sometimes ICSI could cause damage or that it relied on the embryologist's visual assessment rather than allowing nature to self select the strongest sperm, but that time we got all to blast and I have a two week old from that. So ICSI doesn't seem to overcome all sperm quality issues but when that aspect was fine, it certainly did no harm and may even have been a big help. Personally just because it worked, I'd do ICSI again irrespective of sperm issues. Best of luck ☘️

[Applepie7 in reply to MrsOrangejuice]

Thank you.

[JenRoy]

I was told by my previous clinic (when doing OE IVF) that eggs from older women don’t always tolerate standard IVF ie the sperm having a free for all and all trying to fertilise the egg. It can lead to a stress response from the egg and cause it to fail or resist fertilisation. With ICSI, it’s less stress inducing as a single sperm tries to fertilise. I’m not sure if the evidence base but it did make sense.

I took daily growth hormone (very low dose) 6 weeks prior to start of stims for our final round. It was our best cycle since I had my daughter in 2018.

The cycle didn’t work as all 9 embryos were abnormal, 5 never made it to day 5, 3 were unable to be biopsied as were poor quality blasts and the final one was PGS tested and abnormal (trisomy 11).

So our protocol gave us our best chance but sadly my eggs were just too genetically abnormal/old.

But it’s great your consultant has some ideas. Maybe just change one thing? And then do other things next time? If you are able. But change is good 😊 xx

[Applepie7 in reply to JenRoy]

Thank you.

[Hells18]

Currently 6 months pregnant with icsi xxxxxx