31 eggs but only 1 blastocyst

[K_LNB]

I’m wondering if anyone has had a similar experience and can offer any advice. After natural 1st baby, struggled to conceive second time. We were recommended ICSI due to partner’s low mobility count. I have high AMH (30) at age 38 and stims went (too) well with 31 eggs collected, 24 of which were mature and 23 fertilised. But only one made it to blastocyst to freeze. If FET doesn’t work this time, the only advice from the clinic is to try PICSI next time. The clinic themselves even said they were very surprised at our outcome. Any advice appreciated.

[Ytrewq123]

Just a thought but has your partner had DNA fragmentation testing done? I have read that in some cases that embryos not making it past day 3 or 5 can sometimes be due to the male factor and DNA fragmentation can sometimes be a part of that. Wishing you lots of luck with your embryo transfer xx

[K_LNB in reply to Ytrewq123]

Thanks! Yes I understand the PICSI helps with further sperm “selection” in the event of DNA fragmentation. But since the DNA frag test costs more than the PICSI itself we may as well just go straight to PICSI! Albeit it i think the evidence of its benefits are limited.

[Ytrewq123 in reply to K_LNB]

Ahh that is interesting and makes sense!

[JA-fnuk Partner Nurse Fertility Network UK]

Hope you get some helpful replies to your post For more information about PICSI please take a look at hfea.gov.uk Treatment add-ons

Thinking of you

Janet-Partner

[Orangeflowers]

Hello, has your consultant mentioned the possibility of pcos or polystic type ovaries? I had over 20 eggs collected in my 40s but only 2-3 making it to blastocyst and it was suggested I have the latter, though I have no symptoms. The conditions lead to excessive amounts of eggs which are a bit poorer quality. I did have a success so there's every chance for you x

[K_LNB in reply to Orangeflowers]

Thanks, that’s really helpful - had never thought of that so will explore.

[Jaylaa in reply to Orangeflowers]

I had a similar case, did you have to have a specific treatment for PCOS?

[Orangeflowers in reply to Jaylaa]

No. I just had polystic type ovaries. No treatment. Clinicians only mentioned/ noted in passing

[Jaylaa in reply to Orangeflowers]

Thanks, I may have the same condition but not sure if anything would change in my treatment if I was officially diagnosed

[K_LNB in reply to Orangeflowers]

So I just found a scan report from ten years ago which mentions polycystic ovaries sort of in passing so what you say makes sense!!! No symptoms though or otherwise picked up along the way!

[Orangeflowers in reply to K_LNB]

Same for me, nobody mentioned it to me verbally I just saw a handwritten scribble on my notes when I requested them. No symptoms either

[Peony85]

Did you lose more before day 3, or between days 3 and 5? If before day 3, it could be an egg quality issue, but after day 3 sperm kicks in and could be a sperm quality issue too. We had both. We tested for DNA fragmentation and I do think it’s worth doing under a urologist who specializes in fertility as there can be other solutions (eg treating a latent infection) that will solve the issue. We had to go down a surgical route (as well as addressing egg quality issues) as we did IMSI for sperm selection and while it got us better results, it didn’t lead to pregnancy. But with surgically extracted sperm we were able to.

[K_LNB in reply to Peony85]

Thanks for your reply. Most were lost before day 3. Declining egg quality seems likely because of my age. The doctor said it’s plausible that previously my younger eggs compensated for sperm issues (hence east first natural conception) but now they can’t. Will definitely consider a DNA-F test.

[Peony85 in reply to K_LNB]

I remember reading that as well about eggs compensating. For egg quality, there are different supplements, but we switched up the protocol as well and added growth hormone. Good luck.

[Meliana]

I'm sorry to hear about your results. I can only echo what's been said here already that maybe sperm fragmentation test can give you some answers whether sperm quality contributed to results. I can relate because we have 28 fresh donor eggs of which 27 were fertilized and only 2 made it to blastocyst. This was a 31 year old proven donor who had 2 kids of her own so to say we were shocked is an understatement. We also had ICSCI and PICSI done so not convinced PICSI is answer either. In my case my doctor thinks there may be a DNA fragmentation issue that contributed to this. He was already doing lifestyle changes of decreased alcohol/caffeine and recommended supplements so my doctor said if they would recommend donor sperm as solution if he sperm fragmentation is high which is not an option for us. My transfer of my highrst quality 3AA blast with suppsedly 70% chance failed and now have one untested 6 day 3 BA blast left with a 50 % chance of success. I have very little hope left and for me this will be the end of my journey as I can't afford anymore IVF. Good luck to you! Wishing you the best - I know there are also many success stories of one normal embryos making it and having successful transfers.

[K_LNB]

thanks for this reply, I really appreciate it and sorry to hear you got such a disappointing outcome too. Whilst I of course wish you all the success in the world it’s nice to know someone else is in the same boat.

[Anonymou5]

My husband had two ‘normal’ sperm tests, although twice we’ve used picsi was the best quality rounds we got 😃