Low number of blastocyst

[Jaylaa]

I have just finished my first stimulation and egg retrieval. Thirty-five eggs were collected, but only 2 made it to the blastocyst. This was a shock to me, and even the clinic was surprised. I am 42, and I am worried it won't be any better the next time. I am confused now and not sure what to do: proceed with the transfer or try another simulation cycle. Can anyone relate?

[Nabsal]

I think try another one freez these.

[Football61]

Hi, sorry you’re going through a stressful time. I’m 44 and in my first IVF cycle this year, I had 16 eggs collected. The clinic were really optimistic about my chances, but I only ended up with two blastocysts (well, one really - as the other one was very poor quality). I sent them both for PGT-A testing, and they both unfortunately came back abnormal. I’m no expert, but 35 eggs sounds like a lot - did they say whether you might have been suffering from OHSS? How many were mature, and fertilised? If you have a blastocyst that is good-ish quality - is there a possibility of going ahead with a fresh transfer now? I guess you don’t have anything to lose? Wishing you the very best of luck ❤️

[Jaylaa in reply to Football61]

Thank you for your message and I am also sorry for your difficult journey. Fresh Transfer was not possible. Of 35 collected, 25 were matured and fertilized, but only 4 developed and 2 made it to blastocysts. They did not even mention PGT-A testing, can you do it if they are already frozen?

[Olive12345 in reply to Jaylaa]

You can freeze and then test. I haven't managed to get any blastocysts from two rounds but the original plan was to do a few cycles to embryo bank and then test them in a batch.

[Football61]

25 mature/fertilised is pretty impressive. I’m really sorry you didn’t get more blasts - although 2 blasts at 42 isn’t to be sniffed at. Do you mind me asking their grading? I had a pretty big drop-off from Day 1 to Day 3. I had 13 fertilised eggs, but only 3 made it to Day 3. My clinic advised that was due to the poor quality of the eggs (rather than the sperm). My clinic very strongly recommended PGT-A because of my age - and I was also conscious that I didn’t have time to lose transferring embryos that were abnormal. They did the testing before they were frozen - but I think there might be a possibility to thaw, test, and then freeze again? You should ask for advice on the risks of the thawing/freezing xx

[Jaylaa in reply to Football61]

Sorry, it wasn't clear, 25 matured and they were injected with sperm but only 4 developed on day 1. 2 made it to the freezing process. Not sure if I should push for a few more rounds straight away? Will you continue?

[Football61]

I had a second round with my own eggs and got three blastocysts. But they all came back abnormal after PGT-A testing. I had 21 embryos over two rounds and none of them were normal - so I figured I was on a hiding to nothing. I’m in the middle of a donor cycle now. If your two frozen blastocysts are good-ish quality, it might be worth transferring one of them before shelling out lots of cash on a whole new cycle? What have your clinic advised? x

[Skittles11]

Embryo banking will often be suggested if you are also wanting a sibling so this may be something to consider. I tried embryo banking and in hindsight wish I had just transferred what I had as I collected it. You never know how you'll feel though, only what your gut says at the time. Listen to what feels right for you xx

[EmoChild]

I had something similar. With 18 collected, 14 fertilised overnight and only 2 made it to blastocyst stage.

The thing is you only need one to work for transfer. I have friends with similar outcomes and they have been successful, and I am currently 13 weeks pregnant.

[Ses9]

Hi Jaylaa,

Firstly, congratulations on the two blastocysts. I understand how disappointing and shocking it is to have a huge drop off but that is what happens, especially to ladies of our age. Of the 35 collected, how many were mature and not over or under? I think we get so optimistic when we hear large numbers of eggs but then get disappointed when we get so few make it to day 5. A low number at day 5 is normal because the eggs have been through lots of hurdles to get to that stage and most will fail.

I got 16 eggs and only 4 fertilised on my first. I ended up with 2 blastocysts - thankfully good grades but not genetically tested and they were slow developing - only size 1 and 2 on day 5! So problems have been discovered in this learning curve.

IVF let’s you discover issues, especially the first round and then try other things in the second round. It’s trial and error mixed with luck. Maybe your doc will do lighter stimulation? You’ll have to have your debrief discussion with them.

Everyone has a huge drop off somewhere. If you were overstimulated or overreacted to the drugs, your ovaries will bring forth lots of eggs but they might not be good quality or at the right stage of maturation and would be rejected by the body naturally in that cycle. Remember, we’d normally only get one to mature egg and a chance of one blastocyst. So getting two has doubled your chances for that month already!

IVF over 40 is a tough gig, as I’m finding out too. I thought that by having lots of eggs collected and having good amh and afc I’d be able to have two cycles - one to bank and one to do a fresh transfer. Boy I was wrong!! When they say it’s a rollercoaster, they mean it. It’s so heartbreaking at times.

I transferred one and froze the other. Failed. Now I’m looking at another cycle and waiting for the doc to make suggestions. Yes part of me thinks ‘ all that money, pain, dedication and hope to be left with one frozen blastocyst ( the 1bb that they transferred was so slow growing it would never have made it to implantation inside). But lessons have been learnt and questions have arisen to go forward with.

It’s a long road. There are hurdles and pitfalls in the way, when you hit them, it’s a kick in the guts! They say it’s age but then we see women the same age getting pregnant. We think IVF will give us that bit of help we need and in some cases it does but not in all.

Will they give you a double blastocyst transfer? My doc told me right at the start, I would need about 4 rounds. I didn’t see why, when he also said I’d be a good responder but it’s because with age good quality blastocysts are fewer, regardless of egg numbers. IVF is looking for that one or two, which are ‘good enough’.

The way I’m trying to come to terms with it is this - if I have 4 cycles in a year and get 2 good blastocysts each time. That’s 8 chances of getting pregnant by this time next year. Now out of those 8, most likely only 2 will be genetically normal ( if I’m very very lucky, I suspect genetic issues with my eggs as my teenage son is suspected mosaic for Downs and I was 24 when I had him!!).

Genetic testing is growing in popularity and is a good thing but it can also discard some blastocysts, which are mosaic like my son ( perfectly healthy). Realistically, I personally could end up with none to transfer if I tested, although I had seriously considered it. You might find it helpful, you might not.

I wish you luck with your journey! Know you’re not alone and you’re normal! That’s great. Once again, 2 blastocysts is great - you now know you can make them and get to that stage! That’s progress!!

[Jaylaa in reply to Ses9]

Thank you for sharing

[HollyT7]

I have written this post so many times…24 follicles, 16 collected, 9 mature, 3 fertilised. 1 Chemical and two beautiful boys! It doesn’t matter about the number, it’s the quality. Don’t write this cycle off at all! These two could be the two that make it. I don’t think anyone should be telling you to try again and forget these, you could end up with none!

[Football61 in reply to HollyT7]

Completely agree. Two blastocysts at 42 isn’t to be sniffed at…

[Jaylaa in reply to HollyT7]

Thank you

[Jessy1280]

Yes I relate. I started IVF at age 38, got 18 eggs and only 3 made it to blast. All three embryos failed to stick. It came as a huge shock. The drop off was significant. I then did cycles 2,3,4 and each cycle got progressively worse. Similar egg numbers each time but made less blasts and eventually no blasts that were transferrable.

In your situation (as you're a great responder), Id definitely try another round if these two embryos don't work. It could be that you're egg quality isn't great or they you just had an off round. Typically in our forties, our egg quality isn't the best. If you're considering siblings, I'd just jump up another round now. Time really is of the essence as egg quality and egg numbers usually nosedive as we age. All the best xx

[Sandriana]

If I were you I would have transferred one fresh. At a certain age, having many many eggs is not that important as I found out in my experience the qualities are mostly not good after a certain age. Having one good one is the most important. Think about it, they are stimulating your ovaries with unnatural substances that will somehow hinder the quality because you are not 30 anymore, but many women get pregnant naturally at 40+ because they still have at least ONE good egg. That's why I switched to mini to natural IVFs now because at 40+ what's the point? I haven't been pregnant yet but I truly believe in my heart that's the only way I can preserve the quality of the few eggs I have left. You're no longer going to come out with 10 good quality eggs even if the stimulation brings out 40 eggs. I hope this will help you in making your decision.

[Meliana]

I understand the shock of only two blastocysts. I had a failed retrieval of my own eggs at 43 with 7 eggs retrieved, 5 fertilized and none making it to blastocyst. My doctor said turning to a fresh egg donor would give us more chances and she had 27 eggs, 25 were fertilized and only 2 made it to blastocyst. Ivf is really hard and draining financially and emotionally. I would say talk to your doctor to see what they recommend but a positive for you is that you were able to have so many eggs retrieved. Maybe you can do one more egg retrieval. My doctor also let me know that adding human growth hormone or HGH can also help improve egg quality for retrieval. I never tried this though and moved onto donor eggs. So far haven't been successful but have one 6 day 3 BA blastocyst left and trying to figure out how to improve my chances with my last transfer. Good luck to you!

[Flare90]

Hi Jaylaa,

I have been through the same here or maybe worse, two IVF cycles and each IVF resulted in only one embryo (2 in total). I had two transfers and both failed. I was looking for answers and none made sense. I've been told that the sperm is the reason. Although my husband had been taking proxeed for the past 4 months I was not convinced with this a reason.

I went to another clinic, The Dr was amazing and identified immediately the issue. I'm 33 and I have a low ovarian reserve and apparently, my eggs were too fragile. He explained that overstimulation (I was prescribed over 450 stimulation substances) was triggering more eggs but poor quality.

If I have one advice for you is always to expect the least and not get attached. It's not that easy but don't give up as it will be worth it at the end 🥰