I just had my follow up consultation after our second failed round of ivf and desperately looking for advice, and really just somewhere to empty the thoughts in my head.
A bit of a background, husband and I are 35 - I have endometriosis and husband has a history of MFI over the years, although his last two tests have shown optimal results so they are not worried.
First round we got 6 eggs, 3 mature and 2 fertilised with ivf, this reached day 5 but failed implantation. Second round 13 eggs with icsi, 4 mature 0 fertilised. My AMH is normal for my age and my follicle growth is good they say.
They phoned today saying it is my egg quality and most probably down to genetics, but my family have no history of poor egg quality or early menopause. I asked if they think it’s my endo and they believe not. She said if I go into another round of ivf then to expect the same results.
what would you do? I’m wondering if I should have a laparoscopy? Maybe remove the endo? Or just focus on supplements and improving egg quality. I’m feeling totally lost and like I’ve hit a brick wall. Giving up is not an option, I just don’t know what to do next.
Any advice is greatly appreciated. Thank you and sending love to everyone still on this journey xx
I would be looking at a DNA fragmentation test for the male partner. The sperm can look good through the basic sperm test but the DNA fragmentation test will tell you more as they look inside the sperm. I am not very knowledgeable in this area as our focus has been more on me but if you had no fertilisation it could be worth exploring the sperm in more detail. I also think if 4 out of 13 eggs were mature maybe your follicles were not at the right stage for collection. Maybe they collected too early, maybe your follicles could do with pushing that bit further (I think I may have said this previously, sorry if I'm repeating myself).
Sounds also like a second opinion from another clinic could be beneficial.
thank you skittles - I wrote everything down from my your post to ask during my app, i asked about pushing further, double trigger etc. She said she didn’t see it beneficial and that my eggs looked grainy and pitted? It sounded like she didn’t have much hope. I think a second opinion is my best option and I have booked my husband for DNA frag test. Thank you so much xx
That sounds really deflating and I really don't think you can tell from one cycle whether the result will be the same. Plus your first cycle you had a blastocyst. Sounds like they're not thinking much outside of the box to me. I think I have endo too as I have an endometrioma but every doctor I've ever spoken to has said don't do a lap - including an endo specialist! So I'm not sure what to think on that one. You could seek the advice of an endo specialist to see what they think in your particular case xx
it was really deflating and she actually advised I go for a lap 😵💫 as removal of Endo and Endometrioma will give me this best chance. I’ve been reading nancy’s nook on FB and they say excession is the gold standard and increased fertility rates. I have a consultation with endo specialist next week, so will see what he says.
I’ve also found another one based in sussex who looks good.
I agree with you / I think another cycle is worth a shot. I hope you get some answers too xxx
So sorry you are going through this 💔 I would get a second opinion from another clinic if I were you, just to see whether they say the same thing or suggest something different. I believe embryologists can tell a lot about the egg quality when they look at them in the lab. ICSI bypasses sperm issues in general, and if there is DNA fragmentation then supplements are really one of the only things you can do to help (other than checking for varicocoeles etc). What did the clinic suggest to you as a way forward? Sending lots of love xxx
Also as Skittles said, may be worth asking why the eggs weren't mature, maybe the timing/protocol needs changing....? As immature eggs won't fertilise regardless of the quality
thank you hedgehog. It’s honestly so traumatic this whole journey - I had to take a day off work and have just cried. I couldn’t even get an appointment with a counselled to try and support my emotions ☹️ it’s so lonely.
Clinic has suggested dna frag and also looking at sperm proteins of something, oocyte activation maybe? And a lap for me - but she isn’t an endo specialist so I don’t know if I should trust that - especially as she said about removing the Endometrioma which can lower amh.
I don’t want to move to DE without giving mine the best shot, just not sure where to go or wait to do 😔😔😔😔
I asked about protocol and she said changing it won’t make a difference as my response to drugs isn’t the issue. Xxx thanks for replying xxx
Hello hun, you may already be aware of it but I found the book 'it starts with the egg' by Rebecca Fett helpful for improving egg quality, albeit my issue with egg quality was age (I started at 40). I did take the book with a pinch of salt as it's quite full on though. I also feel that seeing a fertility nutritionist really helped my eggs, hard to prove of course but I had much better results after implementing her diet for 4 months odd (and also my son from that round).
I also found I seemed to do better with a change of stimulation drug, for me Menopur worked better, but I think it varies for everyone so if one's not working it can be good just to change it up and see.
So sorry for all you're going through, infertility is so unfair.
thank you, I have just ordered the book so I will give it a shot, I will try absolutely anything atm. I did question changing drugs and she said there’s not much point but I know some peoples eggs mature better with menopur. I am glad you got your son in the end 🫶🏻 thank you for replying xx
my first round we got 4 eggs all fertilised and none got to day 5. I was also told egg quality. Second round we did 5 months later on my request after I went on a low carb diet, lost some weight and took 600mg off COQ10.
Only got 3 eggs but again all fertilised. This time all got to day 5 with 2 top grade.
The other thing we did differently was my husband was asked ejaculate every day for the 7 running up to egg collection.
1st fresh didn’t take and consultant said it was most likely that the embryos had some genetic abnormalities so we went into the frozen cycle pretty hopeless. This however has resulted in our son.
I don’t know if any of that information helps - good luck!!
sorry for the late reply. I can’t remember what the research was, but our consultant is one of the best in the field (Dr Rutherford - he’s got a book) and he said there was some evidence that the remaining sperm would be the ones that could survive and therefore the best quality.
He was asked to ejaculate every day for the 7 days running up to egg collection. Getting the sample sample on the day of egg collection was tough 😂
It does sound like it might be your eggs…but with the second round the lack of fertilisation could mean they over cooked your eggs… you can google and read about that!
I recommend you get the book ‘it starts with the egg’… you can also see key points on you tube…
After listening to videos Re that book, I changed some things in my life to help egg quality and I’m 41.5 years - at last ivf fresh cycle I got a pgta screened embryo…you would need to make any changes to diet 4 months leading to to egg collection…
Some of the things I changed:
Stopped getting nails done/using nail varnish/nail glue;
Stopped eating out of plastic anything and stopped heating food in anything plastic - like ready meals - I don’t drink out of plastic bottles etc;
Stopped using perfume/things with strong scent;
I’m eating lots of healthy fats - avocados, walnuts, eating oily fish three times a week;
I stopped consuming sugar to the levels I did previously- max is one scoop of ice cream every couple of days if that!
I don’t consume caffeine anymore - just decaf and I also had a couple of cups of green tea in the morning.
I don’t smoke or drink alcohol (no alcohol at all)… I never did in last 6 years or so- so that but was easy…
I won’t know if this helped me but it likely did given my age…?
Maybe you could try some of these things/ read that book and try once more to see if it makes a difference? X
My latest advice from my clinic was 600mg coq10 and 75mg DHEA. I have endo, I don’t get many eggs but they do fertilise. AMH being normal is good, and your younger than a lot of women going through it. We used icsi so were told didn’t need dna fragmentation. I take the quad therapy, blood thinners, steroids and progesterone. Even though my blood test etc was normal. It’s a minefield. I asked for a second opinion and she was so helpful. Recommended supplements etc and maybe long protocol, which is new for me. Also recommended probiotics, oral and vaginal. Good luck x
I was told after my first round that my egg quality was so poor it wasn’t really worth me trying again as less than 5% chance of it working. Told me I should go down donor egg route. I wasn’t ready to give up so tried another 2 times and on My third round I got 2 freezable embryos a 4aa and a 3aa. Now sat with my 4 month old baby. Sometimes they are wrong.
Last 2 times we went to Cyprus, it’s much more affordable if that’s an issue for you and personally I received much better care!!
Hello,I was just reading the answers and caught my attention that you did your IVF in Cyprus. How was your experience overall and what is the process? I'm thinking about the period where you use the injections and go for scans before they retrieve the eggs etc if you don't mind me asking, did you stay over there throughout the whole process?
We have done a 1st IVF cycle and did not work. We have a 2nd chance with the NHS, but if it doesn't work we will go private. We have been looking at the prices and are bloody expensive!
So I’m in the lucky position of having a second job where I work from home.. I went off sick with my first job for the whole 3 weeks and stayed out there for the whole thing the first time. The second time I went the day before I needed my first scan, so about a week into the cycle, when you weigh up the cost of accommodation versus the extra cost of the medication in the uk there’s probably not much in it! I guess it depends how flexible you are with your job. If you want to give me a call I’m more than happy to talk it through, just message me with any questions. Obviously I’m biased because it worked for me and there will be other patients who it didn’t work for but personally I can’t fault the care I received, and they performed actual miracles (we had been trying for 16 years previously and I’m 43) x
Thanks so much for confirming. I've heard of other stories where the couple decided to do it outside the UK, and were successful too.
I suppose my main concern will be if this is worth it financially speaking, and I was also thinking about the medications - seems a bit daunting but eager to understand more. If many couples have done it, there must be a reason!
Xx
Hi there, my first round resulted in low quality embryos that didn’t take. My second round I did a total lifestyle, diet & exercise overhaul. I actually think I may have been over exercising so as a runner, I reduced the distances & did a lot more walking & yoga. I also moved to reduce plastic use, cosmetics, household cleaners etc. Someone told me a lot of health issues stem from poor gut health so I took probiotics & ate a more balanced diet( no fad diet just more fruit & veg etc). Second round we did indeed get better embryos. I should add, we didn’t use expensive supplements and still got much better embryos. Good luck going forward.x
You've been given some excellent advice from others here, I just wanted to say that if you have endo you can do a down reg before your cycle, which should reduce it. Somebody on here recommended to me a clinic in Spain who do all the tests on both partners a lot cheaper than in the uk. I found my answer there and am now 20 weeks pregnant. I would 100% get a second opinion. It doesn't seem right to have 13 eggs and only a few mature.
I’m so sorry you have been going through this, it is very difficult but don’t lose hope.
Look into Mercier’s therapy, which is deep pelvic massage and caster oil treatment which has shown to improve egg quality also acupuncture and Chinese medicine.
Have your active vitamin B12 ,Vit D ,iron,ferritin,thyroid levels checked.Vit E ,vit C & zinc supplements are helpful improving fertility.Vit B12 supplement give to a male can improve their sperm count from 40 million to a hundred million.My knowledge is from from 50 yrs of midwifery & 40 yrs fertility awareness educator.A vit b12 def.can cause recurrent miscarriages,infertility,PCOS & anaemia.
thank you everyone for your wonderful responses xxxx
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