I've just been through my 3rd fresh cycle. I got 10 eggs, 9 mature and 9 fertilised. On day 5 none had reached blastocyst. We transferred 2 compacting morulas which resulted in BFN. My question is, what now? Has anyone been in a similar situation and found out why their embryos stopped progressing? Our Dr has suggested either one more with my own eggs or to go to donor egg and I'm not sure which route to go down. Here is my history:
Diagnosis: Severe male factor (using donor sperm), lowish AMH for my age
1st cycle short protocol - 10 eggs, 3 fertilised, Day 3 transfer, ectopic pregnancy
2nd cycle short protocol - 8 eggs, 4 fertilised, Day 5 transfer, no blastocysts but transferred a compacting morula, BFN
3rd cycle long protocol - 10 eggs, 9 fertilised, Day 5 transfer, no blastocysts but transferred 2 compacting morulas, BFN
Thank you for your help. xx
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Rhubarb5
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It's always so tricky to give an opinion on the what next questions as it depends how emotionally, physically and financially spent you are.
I just wanted to share my experience.
We have moved onto donor sperm now for our next cycle. We are doing one last cycle(6th cycle) with my own eggs. Our last cycles have been IVF/ICSI with our own eggs and own sperm.
However, I am so conscious of my age, that I would like to be able to carry a baby whilst I am 'youngish' and don't have any health problems so am prepared to move on to double donor if our next cycle doesn't work out.
Could ICSI with your own eggs and then move on to double donor after that be an option.
I don't want to make assumptions, but having recently done all the research for donor eggs. It can be quite expensive depending on where you go... so maybe something to balance up also.
Good luck on your journey... we will get there in the end.
Thank you for your reply and for sharing your experience. All of our cycles have been ICSI so far as we are using donor sperm which has been frozen. I guess we could try a different sperm donor - maybe I'm just not compatible with that one. Good point about the cost of donor egg. If we decided to use a donor egg I guess we then need to decided whether to do double donor or donor embryo. Best of luck with your cycle. xx
I’m sorry to hear the outcome of your cycle. That’s so hard. 😘💐
My last cycle of IVF I had 3 embryos that stopped growing at day 3. My consultant suggested moving to donor eggs and I went with it. However, I completely trust my doctor and know him very well. I was also just ‘done’ and wanted to be pregnant ASAP.
So it depends how you feel. If you have time, you could seek a second opinion from clinics that specialise in poor responders (I think ‘low stimulation’ can work well for poor responders, but never really looked into it).
Thank you for your reply. I'll see what my dr says in my follow up. I just don't know how much more of the protocol can be tweaked. It's all just trial and error isn't it. xx
Hello hun, I think I experienced something similar in that I always got good egg numbers and good fertilization rates, but after my first and second egg collections I struggled with poor embryo development (first round 11 eggs to 1 good blastocyst, second round 15 eggs to 1 good blastocyst, 1 C grade blasto, and 1 very early blasto). I found the supplements advice in the book 'it starts with the egg' helpful for better 'energizing' my eggs, and saw a fertility nutritionist which I also felt helped a lot (I was on her recommended diet for about 4 months before my next egg collection). With my third egg collection I found I got much better embryo development, as well as slightly more eggs (18 eggs to 6 good quality blastocysts). All that to say, if you were going to try another egg collection I would really recommend a diet and supplements program for 3-4 months before your next retrieval.
Wishing you all the very best of luck on this journey, which can be so incredibly hard at times.
Thank you for your reply and for sharing your experience. I have read It Starts with the Egg and I asked my dr about supplements. The only one I have ever been recommended to take has been Ubiquinol (CoQ10) which I took for my previous 2 cycles. I know DHEA is in there and melatonin so I guess I could ask about those. A fertility nutritionist might be helpful. I feel I eat well, always eat home cooked food and plenty of protein and veg but maybe there is something I'm missing. Thank you for your suggestions. xx
For me I do feel DHEA really helped, but I was older (40 for all three egg collections) and had my DHEA-S and testosterone levels checked before starting, your circumstances might be really different/your levels might already be right. I will say I was never recommended any of these things by my clinic, I found them quite 'conservative' and felt they kind of just assumed that because I was older there was nothing that could be done. I didn't try melatonin. But all that said I definitely don't want to come off as if I'm suggesting there's an 'easy' solution, it sounds like you've already tried a great deal and put a huge amount of hard work in to this.
Thank you. I'm leaning towards doing one more with my own eggs and throwing everything at it. Thank you for replying and for sharing your experience. xx
I’m sorry you’ve gone through 3 egg retrievals without success so far-I had two failed cycles which I found devastating and frustrating. We got a total of 3 average-poor quality blastocysts from these first 2 cycles -the embryos were not tested but I did a fresh transfer with each cycle and both failed. We did not have any diagnosed male factor and our main problem seemed to be getting embryos to blastocyst- numbers of mature eggs and fertilisation rate was okI then did a third egg retrieval the week I turned 38. That one yielded four blastocysts - 3 good quality, 1 average quality (again untested) I’m currently 13 weeks pregnant from a single fresh transfer from that cycle
There are so many variables with IVF, so I think it’s impossible to say if anything we did made a difference, but here are some thing that were changed that third cycle that I believe may have helped:
1. Gonal F only stim (previous protocols had been a mix of fostimon and meriofert and then meriofert only. ) My doctor’s approach to this seemed to be entirely based on trial and error, he had no reason to believe one med would work better than another, just seemed to think it was worth experimenting to see what happened)
2. The lab acquired an embryoscope between my second and third cycles, so the embryos were left undisturbed on cycle 3, whereas previous cycles they were handled on the morning of days 1,2,3 and 5 in order to monitor progression
3. I ate at least 60g protein/day and limited carbs to one carb-based meal a day based on a couple of small-scale studies I read about. Started doing this about 2 months before I started stims
4) In addition to following the advanced supplement plan from the book It Starts with the Egg, and omega 3, which I had done for the first 2 cycles (with the exception off DHEA and melatonin), I added the following supplements about 2 months before starting cycle 3- PQQ (20mg), Tru Niagen (300mg), açai berry (1500 mg), melatonin (3mg). PQQ and NAD precursors ( which is what tru niagen is) have promising mouse studies behind them. There is a clinic in the US (maybe CCRM…?) that gives an açai berry supplement to all patients and have done some studies which seem to indicate it improves results. All these supplements are focused on improving egg quality and specifically seem to help us slightly more mature women. Some clinics are cautious about recommending them because of lack of evidence/studies showing they are safe and effective, but many do
In my own personal experience, I do believe that the protein and supplements helped me, but it could be pure coincidence that we had an improvement with the third cycle. Whatever it was, it does show things can improve.
Thank you so much for replying and for sharing your experience. That's great news about your pregnancy. Yes I agree, so many variables - I read on this forum somewhere that ivf is 'an art not a science' and I think that's so true. All totally trial and error as you say. I've tried Gonal F for my first cycle and Pergoveris for my 2nd and 3rd. That is interesting you say about embryos not being disturbed, I have wondered if this makes a difference but I always ask the embryologists to check them in case I need an early transfer. Thanks for sharing about the supplements you took. So did you take DHEA in the end? I have read the book but I have only ever taken Ubiquinol (CoQ10) as this is the only one my dr seemed to think might make a difference. I have been told I can try Human Growth Hormone with my next cycle but I'm not sure I want to. I think I'll dive acai berry a go if I do another another cycle, thanks for recommending. All the best for your pregnancy. xx
Yes it’s all a very emotionally and financially draining trial and error, isn’t it? I didn’t take DHEA that cycle as I felt a bit wary about it and we were already trying a few different things. My plan was to add it in before my fourth cycle of the third had failed (the third was cycle 2 of a 3 cycle package, so we knew we were doing one more.) I think if I’d ended up doing a fourth cycle and used DHEA and it had failed then at that point I would have felt like I’d tried everything possible to improve my egg quality (except growth hormone, but I don’t think this was something my clinic offered, so would have had to go elsewhere for it), so we would have had to have had a good think about how to proceed from there. I would also say that using an egg donor and our feelings around it is very personal and individual to each of us and if you feel it’s something you want to consider now then it’s a very valid option. You don’t necessarily have to try everything at any cost to make it work with your own eggs if you feel using a donor might be the right choice now. Wishing you success next time whichever way you go xx
Hi Rhubarb, whenever an embryo fails to reach day five, it is always worth asking how they progressed forms dats 1 to 3. If they progressed well in the first 3 days, it may not be your eggs. I also had one round when no embryos made it to blastocyst. At the time, I thought it was the high stims I was on but my consultant said the sperms DNA comes into play between days 3 and 5. Some articles below about how sperm quality can affect embryos becoming blastocysts
So I would find out how many of your 9 fertilised eggs were still going strong at day 3. You may also want to try a day 3 transfer again. My success came from a day 3 transfer which I insisted on because I was scared that no embryos would make it to day 5.
Thank you so much for replying. That is really helpful. I know that 7 of my embryos were doing well on day 2 but I didn't get a day 3 update so I'll definitely ask about that. I think it would be relatively easy for us to change sperm donor so that might be worth looking into. Good idea about the day 3 transfer. I asked about planning a day 3 transfer with my last cycle - the Dr said we could if we wanted to but after having a chat with embryology I decided not to (with my 2nd cycle my best embryo on day 3 had completely fragmented by day 5 and my worst was now my best). But I think we will do that next time and ask for a double transfer. Thank you for your help. xx
Just wanted to say sorry to hear your 3rd Round didn't go well. I am soon to go into our 3rd so many mixed feelings and so much you can't control. Be kind to yourself! I know it is hard 💜
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