Zero Fertilisation/DOR - questions to ask at review?

[Clayhugs]

Hi, hoping your collective mind could help?

I've just finished my first IVF cycle using a long protocol and ICSI which resulted in 3 eggs of which none fertilised and I was hoping you might be able to suggest some questions I should ask at the review meeting?

For a bit of history...my husband has 1% morphology but his volume and mobility are both normal. I have Diminished Ovarian Reserve at 3.5pmol. All other results seem normal. I'm 35 and husband 36. We had a natural pregnancy in 2020 but it was ectopic so it resulted in a miscarriage.

During this cycle, I had 4 follicles but only 3 eggs were retrieved, none of which fertilised normally.

Has anyone been through similar results and found a different treatment more successful, or had better luck next time? Or know of the type of questions I should be asking or pushing for?

We can only afford 1 or 2 more rounds so I don't want to regret not thinking of a question that might help the next time.

Thank you so much in advance, xxx

[Skittles11]

Hi

I'm sorry to hear about your recent IVF round.

I too have a diminished ovarian reserve. What I would suggest is that you look in to doing short protocol rather than long protocol. Short Protocol can be more effective for those of us with limited reserve (not in all cases but certainly in some cases).

Do you know whether the eggs retrieved were mature? How big were the follicles when they told you to do the trigger?

Xx

[Clayhugs in reply to Skittles11]

Hi Skittles, thank you so much for replying and offering suggestions. I'll definitely ask about the short protocol. It feels so counterproductive to shut your ovaries off but I'm sure there's a good reason.

I expected to have more eggs to work with as my first scan before treatment showed 5 follicles but I guess each month is different.

I'm sorry you have the Diminished Ovarian Reserve too - it's very frustrating to not have many to work with.

The follicles were between 17-19mm and only two turned out to be mature enough to fertilise. xxx

[lmno]

Hi Clayhugs,

I'm so sorry to hear about your experience - I've been there and felt crushed with disappointment after such a long build up. In our first round of IVF I had 11 eggs, and none of them fertilised.

I went into our review meeting with lots of questions, mostly like why has this happened and does this give more information about why we weren't getting pregnant naturally (ours is unexplained infertility). I have to say our consultant wasn't very helpful and mostly just talked about the next cycle.

Our next round we did ICSI which was much more successful. We got 7 eggs and 3 of them fertilised (our third attempt resulted in my daughter who is now 20 months). I just wanted to say you're not alone and it doesn't mean it's the end.

No question is too big or small though so just write down anything you're wondering about and don't be afraid of carving out space to ask them in your meeting.

All the very best x

[Clayhugs in reply to lmno]

Thank you, Imno for sharing your experiences with something similar. It is reassuring to hear you had a more positive second round and congratulations on your daughter.

yes, I am concerned about not having a particularly helpful review so definitely want to go into it having some solid questions to ask.

Thank you for your good wishes. xox

[DianeArnold Partner Nurse Fertility Network UK]

Hi Clayhugs. I have sent you a direct message. Diane

[soccerkt6]

Hi lovely

I'm really sorry to hear that your cycle ended with disappointment. It's such a tough situation, especially after a long cycle where you've been on meds for so long.

I would strongly suggest having your husband do a sperm DNA fragmentation test. My husband's semen analyses were similar to yours (normal count, concentration, motility) but low morphology of 2%. After our first failed cycle our clinic recommended that he test for DNA fragmentation, and his results came back with high fragmentation. In our case, it meant that my eggs fertilised just fine but the vast majority stopped developing after three days, but I know it can also result in failed fertilisation. If his results do come back high, there are def things you can do/ investigations to undertake to figure out the cause of the fragmentation, and you'd also want to add PICSI or IMSI to your next cycle.

Sending you a big hug xx

[Clayhugs in reply to soccerkt6]

Hi Soccerkt6, thank you for sending me your response and offering your experience. I will definitely push for that test. You'd wonder why they don't explore these things first so they know the potential obstacles - especially as it is such a costly experience.

I will have to check if our clinic offers PICSI or IMSI.

I just read your profile there and I'm just up the road from you in Belfast. I intend to check a few things out before our next cycle too and see if there are any ways of making our chances a bit more favourable. We only have 1 or potentially 2 rounds left to play with. Best of luck with it all. Sending hugs back. x