fertilisation rate changes

[Watermelon82]

hi all seeking any stories of people who have had drastic changes in their fertilisation rates between cycles. I have had one icsi cycle where we had no eggs fertilise (4 mature) and about to have my second cycle (split ivf and icsi), and I’m terrified we will have zero fertilisation again. Only positives being it was a small number of eggs first time around. I’ve read about everything (oocyte activation etc etc) and we’ve had sperm fragmentation, karyotype testing etc all with fine results. Looking for some hope as I’m very petrified of repeat devastation 🤞🏼♥️

[MrsOrangejuice]

First cycle we had 9 eggs and of those 4 fertilised with ICSI. Got three good blasts from that but clinic said the fertilisation rate was borderline to poor. We weren't even down to do ICSI as my husband's samples had always been fine but on the day they said there was a quality issue. The next round we got 5 which all fertilised with ICSI and went to blast and we've just had a rather disappointing one egg collected which did fertilise with ICSI and waiting to hear if we can transfer. So we went from less than 50% first round, to 100% on second and third. I quizzed the clinic what happened first time and they said it was the sperm issue and ICSI couldn't solve it, but you never know it could also have been that the egg quality was better when there were fewer.

[Watermelon82 in reply to MrsOrangejuice]

thank you so much for sharing! I was so naive to think fertilisation would be such a hurdle! Best of luck on your journey 🧡

[DreamingOfTwo79]

Hello. We did PIMSI (which is IMSI plus you add hyaluronan to the sperm culture to spot those sperm deemed genetically normal) and had the following rates across two cycles:

Cycle 1: 9 mature eggs, 6 fertilised, 2 good quality blastocysts but after PGT-A testing these were deemed aneuploid

Cycle 2: 7 mature eggs, 3 fertilised, 3 good quality blastocysts and after PGT-A testing 2 remained that tested euploid.

Fertilisation rates are not always a reliable indicator for embryo quality. We had worse fertilisation in our second cycle but embryo quality was better.

[Watermelon82 in reply to DreamingOfTwo79]

thank you so much, I think I’ll take up gambling over ivf, utterly confusing! 💚

[SR90]

hey, I can see you’ve just followed me so I hopefully you can see my story. We did icsi because of sperm quality.

We did have failed fertilisation with icsi… twice!

After the first round we were shocked as we got a good number of eggs but zero fertilisation.

Second round the clinic changed our medication in the hope for better results, still zero fertilisation!

Third round the clinic introduced the solution (oocyte activation) and we actually got some fertilise! We managed to have 1 low quality (not quite blastocyst) transferred in but with no success.

At this point I was sure the activation solution must have made the difference from zero fertilisation x2 to fertilisation. However I was still convinced something wasn’t right.

My partner paid for more tests and turns out he had varicocele veins which were quite bad. We decided to have these operated on. Waited the 6 months recommended before starting another round.

Fourth round - 4 good quality embryos! Grade A x1 (day 6) grade C x2 (day 5 and day 6) and grade D x1 (day 5).

We had - grade C and D put back in. Although they both turned into little embryos, we sadly lost one at approx 7 weeks. I am currently 32 weeks pregnant with the other one.

I hope that helps a little? The clinic did say zero fertilisation is rare and on the first round it’s a bit of a guessing game. My only advice really would be do your research, ask for everything and if you have any thoughts of your own, get them investigated (although it looks like you’ve done quite a bit of this).

Has your medication changed for this second round? x

[Watermelon82 in reply to SR90]

Oh thank you for taking such time and care to reply! I saw your story after some endless scrolling here and thought I’d note it for safe keeping. This is really useful, thank you for such detail. I’m so absolutely thrilled for you with your beautiful news, what a bloody fight you have had so enjoy every minute.

Yes I have had a change of meds and 1.5 triggers. I go in for egg collection tomorrow. Just very anxious for the call the following day. 🤞🏼

[SR90 in reply to Watermelon82]

It really does feel like a lifetime of waiting just for that first phonecall! All the best for tomorrow and Thursday. Would love to hear how you get on x

[Watermelon82 in reply to SR90]

….we unfortunately only got 4 eggs out of 13 good looking follicles, and they decided to do straight ivf. No fertilisation occurred whatsoever. I think we are now more intrigued than anything. They have suggested calcium ionophore with icsi next time to hopefully trigger activation.

Had your partner done a sperm fragmentation test that led to the discovery and surgery? Thank you again 🙏

[SR90 in reply to Watermelon82]

Sorry in advance for lengthy reply… I’m really sorry to hear this happened again to you 😔.

What medication have you tried so far?

I think the calcium activation is a good route to go down, I believe it’s what helped both our rounds that had some fertilisation. It may not be the whole solution (like with our 3rd round), but there is currently no test to see if the sperm is missing this solution so even if his sperm appears healthy, it could still be missing it. We actually took place in a trial that I found, testing men to see how many were missing this calcium.

After our 3rd round we suggested fragmentation testing etc to the clinic and they said we can, however it won’t change the outcome. The outcome of the testing would be to try ICSI, which we were already doing due to poor quality sperm.

I had previously suspected (thanks to google) varicocele veins due to the poor sperm quality and an obvious vein on my partners testicles. We were dismissed by the GP (almost laughed at) because “the veins are not visible from the outside”. I ignored my instincts. Eventually, we paid a private consultant in London who ran several tests (X-rays, blood tests etc) and when we sat down with him he said… well… you have 2 very high grade varicocele veins that meet the criteria for surgery!

As you can imagine, I was relieved but angry. We decided to pay to have the surgery privately as the nhs wait was over a year just for our first consultation as it was deemed non urgent. He had the surgery within 2 months of our meeting.

[Watermelon82 in reply to SR90]

Oh thank you again. My partner’s sperm has come back looking very good on every test so they seem more interested in an egg problem. We had binding but no fertilisation. I also think this calcium/plc zeta thing could be at play but all the studies I can see on this (to test) are in Europe (I’m in Australia). Our embryologists in the lab are saying try the calcium, and I don’t think they’d be suggesting something futile so fingers crossed. It’s just heartbreaking as you know.

First round I was on gonal f and second round gonal f and pergoveris, both with an ovidrel trigger (unsure if med names are same for you).

I so appreciate your time in replying, now to go and see if the veiny testicles are also at play here , the thought of them having to endure something instead of us is quite nice 🤣 🧡

[SR90 in reply to Watermelon82]

I don’t have much experience with egg I’m afraid as although mine results came back at slightly low AMH for my age, it never really concerned them as much as the sperm.

That’s a shame, I’m in UK. It’s all very new here hence no testing made available yet and still going through trials. I think I just stumbled upon it. Glad they are recommending it though, there’s nothing lost from trying it at least.

Definitely heartbreaking, I completely understand!

We did Gonal f in the first round as our stims medication and then Menopur in all the other rounds. Menopur is supposed to create less quantity but better quality eggs. Not sure if you have that over there? We also did Ovritrelle at 38hr trigger.

haha it definitely was nice to sit back and let him endure some of it 😬. Feel free to private message me if you have questions! Always here to help x

[Kitkat10]

yes I had;

4 out of 7

2 out of 9

1 out of 3

4 out of 6 🤷🏻‍♀️

And I used donor sperm which has to be to be top quality so in my case, I think the variability must be egg quality.. however my 1 out of 3 is now by 1 year old little boy so, to me, there seems no rhyme or reason when the right little embryo comes up. My consultant described it as a ‘lottery’ which disturbed me considering how much money I was (am) spending. Each cycle can be very different, keep going, it really does only take one 🍀 x

[Watermelon82 in reply to Kitkat10]

fascinating! All the same donor? Thrilled you got your little boy. Thank you for sharing! 💜

[Kitkat10 in reply to Watermelon82]

yes all the same donor and always described as excellent quality sperm. But i was 39 when I started so I think the variation was down to me

[prudacity40]

Hey there, we had a pretty poor response with my first cycle and the embryologist said there was no guarantee the next cycles would be any different, especially since our clinic does’t check estradiol or FSH levels mid cycle. Anyhow, here are the results from my first and 2nd cycles (which we just did):

Cycle 1: 15 eggs, 4 mature and 1 M2, all 5 ICSI, 3 fertilized, 1 day 6 blastocyst with fragmentation so nothing to freeze.

Cycle 2: 25 eggs, 10 mature + 2 M2, all 12 ICSI, 12 fertilized. Today was day 5 and I had 7 early blastocysts, 1 Morula, 3 Morula with fragmentation, and 1 remained a single cell embryo which didn’t progress past fertilization. Embryologist says the 7 early blastocysts look “really good” and will be ready to biopsy tomorrow, we may possibly wnd up with 8 if the morula turns to blastocyst by tomorrow.

We changed our stimulation protocol, I started supplements after the 1st cycle and my husband started eating healthier too. I’m 40 so egg quality was definitely a concern. We have unexplained infertility and have 1 child together by natural conception.

[Watermelon82 in reply to prudacity40]

thank you for sharing your journey, and great to hear you’ve had a fantastic round. Fingers crossed for you. X

[prudacity40 in reply to Watermelon82]

Fingers crossed for you too! I saw your results after I responded to your post. My doctor didn’t have an opinion one way or another regarding supplements because he stated there wasn’t enough research, but I swear my supplements made a difference. I’ll know more once I see what happens tomorrow but I would definitely recommend supplements to improve quality and results…

[Watermelon82 in reply to prudacity40]

thank you, what are you on? I’ve been on CoQ10 and melatonin along with normal prenatal vitamin. My partner and I are generally pretty health conscious so I’m a bit stumped on what we can do diet wise, we’ve done pretty low carb for three months.

[prudacity40 in reply to Watermelon82]

I am taking a prenatal, coq10 (Ubiquitol), probiotics, Choline, Vit C, Melatonin, gave up all caffeine and artificial sugar, increased water intake. I also do acupuncture sometimes and have been trying to be more mindful to relieve stress. My husband just took his health up a notch (not necessarily low carb, just more fruits and vegetables and gave up alcohol). I agree with mmmangos to look into a naturopath. I’ve also been looking into reducing our exposure to toxins by making some changes to our cookware, products we use, etc. For example, no plastic, only using cast iron cookware, always filtering our water, avoiding processed foods, looking at ingredients in cosmetics, hygiene products. It can become a lot but so many studies have shown how many toxins we are surrounded by and how those affect our fertility.

[mmmangos]

Hi, my only advice would be to see a really good natropath who specialises in fertility. It is amazing how many things they can check that the fertility specialists don't.