0 eggs at 4th egg collection - empty follicles - have you had similar issue or have any advice please?

[Lily_82]

Hi All,

At my 4th egg collection 0 eggs were collected

Previous 3 rounds I was on 450 Meriofert short protocols and had 7, 7, 4 eggs with 3, 2, 1 blasts. At 3rd collection had 12 follicles over 17mm but only 4 eggs as most follicles were empty.

I have changed clinic for 4th cycle and was on 375 Gonal F short protocol after few weeks of norethisterone and testosterone gel. I had 3 follicles over 17mm but all were empty. They have checked my hormone levels to see if trigger injection was taken correctly and was confirmed that was the case. From what I found on “google” I might have empty follicle syndrome and nothing can be done about it?

My AMH at the beginning of last year was 4.2 and I am 41 now. I still have 1 cycle left in my package and consultation in 2 weeks but I seems to be getting worse results with each collection and loosing hope...

Was anyone in a similar position or would be able to advise anything for my next cycle please? Should I suggest to come back to drugs from first 3 cycles even if with 3rd collection most follicles were empty or perhaps there is anything else what could help in this situation? xx

[DianeArnold Partner Nurse Fertility Network UK]

Hi Lily. Looks like you’re not going to get many eggs. However, the original protocol was delivering a few eggs, so perhaps go back to that regime. Good luck. Diane

[Lily_82 in reply to DianeArnold]

Hi Diane, thank you for your reply. I have changed a clinic to try something new but looks like it might not been the right choice. I do appreciate that won’t get many eggs but 0 is very disappointing xx

[Skittles11]

Hi Lily.I have also had a cycle with no eggs collected.

It can feel very devastating and really shock you when you wake up to learn that news even if you weren't expecting too many eggs.

A couple of questions -

- how long were you stimming for?

- did your clinic test your oestradial level whilst you were stimming?

- you say you took northisterone. Was this to down regulate you?

- what was the rationale on dropping to 375 rather than 450?

Xx

[Lily_82 in reply to Skittles11]

Hi Skittles,

Thank you for your reply and sorry you had to go through it also 🙁

- I have been stimming for 11 days, originally planned for 10 but after 1st scan increased to 11 (in my previous cycles 11-12 days)

- oestradial level was never checked, should it be? To be honest I have never heard of this 🤔

- I was told norethisterone was only used for them to plan egg collection in advance, I was not happy with it but apparently they do it with everyone even with short protocol 🤷‍♀️ I have just googled and looks like it is used for downregulation as well. I was taking it the month before from day 16 for 10 days. Do you think that might be the problem?

- I was not aware they were dropping dosage until seen delayed treatment plan but will ask at next consultation

xx

[Skittles11 in reply to Lily_82]

Okay so firstly I think those follicles could be pushed a bit longer to get them a bit bigger. After my no eggs cycle my clinic pushed my follicles to a bigger size and the subsequent cycles did go a bit better (although still no live birth).

I don't think all clinics test oestradiol through a cycle, my first clinic didn't but my current clinic do. It can be one indicator as to whether the follicles contain eggs as you should see the oesradiol increase as you are stimming.

I thought northisterone was used as down regulation but maybe it has other uses. I found when I down regulated on buseralin my ovaries didn't want to wake back up and that was my no egg cycle. Short protocol without down reg has always been better for me with low ovarian reserve. Did you have this drug in your previous cycles?

I find also I respond better to natural FSH than synthetic (meriofert or menopur vs Gonal F). Could be similar for you.

Hope that helps. Let me know if any questions.

Hopefully others will be along with other advice and input xx

[Lily_82 in reply to Skittles11]

Thank you for your comments, I appreciate it.

I apparently had 9 follicles this time and 3 bigger size within them, will definitely question stimming for longer and oestriadol levels.

I have not used norethisterone before and will avoid it if the clinic let me xx

[Piggypiggy82]

Hi Lily! Something just occurred to me when I read your post. If the clinic thought the results were down to a trigger fault, even though there wasn’t one, might you be someone who would benefit from a double trigger? I’ve seen it mentioned before but will have to defer to others on whether it’s something that might be beneficial in your circumstances. Although having said that, I think there’s something in Meriofert (is it LH?) that isn’t in gonal-f, so perhaps that’s what you need in your protocol to make sure you get those mature eggs. X

[Lily_82 in reply to Piggypiggy82]

Hi Piggypiggy,

Thank you for your reply.

My trigger was Gonasi 10,000. I am not sure if there is a higher one?

You are correct, there is LH in Meriofert and looks like it might work better for me 🤔 xx

[Piggypiggy82 in reply to Lily_82]

I think maybe I should’ve said dual trigger rather than double 🙈 Defo worth asking your consultant about, but if you go back to Meriofert perhaps it won’t be necessary. However, I did read somewhere that too much FH can be a problem too, so definitely worth checking whether your consultant would recommend part Meriofert, part gonal-f. I’ve heard it can do the trick for some people 💪🏼 xx

[Savvy_teapot]

I don't know what to say apart from look after yourself. It sounds like a super tough situation 💞

[Lily_82]

Hi Savvy_teapot,

Thank you for your message.

I just had a look at your profile… congratulations! 💙 xx

[Turtlebug]

Hi Lily. Any luck with the ivf?

[Lily_82 in reply to Turtlebug]

Hi Turtlebug,

No luck yet but after that done 3 more OE cycles with 4, 1 , 4 eggs. 0 eggs is devastating but it doesn’t mean it will happen again.

I had a look at your profile and looks like the same has happened to you, was it your first cycle?

[Turtlebug]

2 nd cycle but different clinic. Seems like my Amh dropped by a half in a space of a year. X