Follow up question ideas needed

[Mlove12]

Myself and my partner have our follow up consultation tomorrow after 8 eggs failed to fertilise (4 immature, 2 didnt fertilise correctly, 1 mature but didnt fertilise and 1 abnormal). I also have low AMH.

Does anyone have any follow up question ideas for tomorrow? We’ve used our two NHS and have agreed we would go one more time which we will fund, or get a package deal if we feel it’s not going to cost an arm and a leg with all the meds and tests on the side!

Any testing suggestions etc people have found really useful in similar situations with no fertilisation and low AMH? I have never had a positive test so also think it may be an implantation issue and considered autoimmune testing as I have autoimmune issues too.

Any recommendations welcome x

[Babytocome]

I don’t have a positive yet, but have a look on YouTube “ the egg whisperer” it is a fertility doctor from Harvard … ivf after 40( the reason is that she mentioned few supplements that might help)

I found her very informative, if I would have known those things before the money I have spent!

[Eloquentia]

I recommend reading 'It all starts with an egg'. Also if you have low rate of fertilisation, it is worth exploring ICSI. Good luck!

[JA-fnuk Partner Nurse Fertility Network UK]

Take a look at hfea.gov.uk [Government Fertility Regulator] Treatment options and Treatment add-ons for more information.

Wishes you well with your future treatments

Janet

[Babytocome]

I also forgot to mention, besides ICSI I found out something called PICSI, it choose the most mature sperm before use the ICSI on each egg. ( I didn’t know this when I did my IVF s in plural!)

[DreamingOfTwo79]

Hello Mlove12, I am sorry you are feeling deflated after your initial two rounds. I don't know your workup details and whether male factor infertility has been duly investigated ahead of your two cycles but I am happy to share what worked for us in so far as that the protocol we followed across two back to back embryo banking cycles yielded a total of 5 good quality blastocysts which we are currently having PGT-A tested, when our consultant, while being very supportive, did caution that based on our poor prognosis workup the likelihood of having nothing to transfer after two cycles is stronger than our chance for success.

Based on our poor prognosis workup (low AMH, advanced maternal and paternal age, recurrent miscarriages, high sperm DNA fragmentation) our consultant suggested we try back to back embryo banking with PIMSI as fertilisation method (a combination of PICSI and IMSI, i.e. they add hyaluronan to the sperm culture and the idea is that only structurally (ergo chromosomally) normal sperm would bind to that substance and these identified sperm are then put under a special microscope that uses a much higher magnification than the one used during ICSI in order to look at the head, neck and tail of the sperm in detail to ensure only the best quality looking sperm is selected for fertilisation). She also recommended a list of supplements which we had been taking since July (our collections were in early Oct and early Nov) which included 3 x 25mg DHEA for me. My protocol both times was a short cetrotide protocol of 225 iU Meriofert/Fostimon, the human growth hormone Zomacton 4mg on alternate days and a 10,000 iU Gonasi trigger. For my second cycle I was further prescribed 3mg Melatonin at bedtime. There are some interesting studies out there on the benefits of using Melatonin in IVF like this one: ncbi.nlm.nih.gov/pmc/articl...

If you are prepared to emotionally and financially invest into additional rounds it is worth asking about embryo banking cycles and to focus on selection of the best quality looking sperm (PICSI, ICSI, IMSI or PIMSI) as well as taking measures with a view to improving egg quality, follicle growth and resilience (DHEA, Melatonin, human growth hormone). Wishing you the best of luck! x

[Mlove12 in reply to DreamingOfTwo79]

Hey, thank you so much for your detailed reply. There’s so many things I feel could be going wrong it’s difficult to pin point it! Ive now been advised to look into autoimmune at a different clinic and decide on short or long protocol, so we will see! Have definitely taken your advice on board and it’s very much appreciated, wishing you lots of luck too x