Failed Fertilisation with ICSI

[Sweet_Chilli10]

Hi everyone,

Me and my partner have just had our first IVF cycle. We had originally decided not to do ICSI as my partners sperm parameters were normal.

I have a low AMH and had a low AFC of 4 at the start of this cycle, but against the odds I did respond to stims better than I thought and we managed to get 3 eggs at egg retrieval. Sadly only 2 were mature and because we had a low number of eggs we were advised to do ICSI.

We had the call this morning that neither had shown signs of fertilisation, but they would check again tomorrow. We were then told by the embryologist that normal IVF may of given us more success so I’m just really confused. Has anyone got experience of low AMH with ICSI or normal IVF? And has anyone ever had eggs that have fertilised later? Clinging on to some hope that things could change over night but not feeling very confident.

Thanks,

H X

[Memacha]

I had a similar round but with only 2 eggs and neither fertilised with icsi. They didn’t give it an extra day. Just to say that despite that terrible cycle, I’ve had much better rounds since with more eggs and better fertilisation. My husband’s sperm is normal but they keep recommending icsi due to low amh. We also did zymot on our most recent round and actually managed to get 4 day 5 blasts! Maybe you could speak to the embryologist to understand whether traditional or icsi is better for your situation if this cycle doesn’t work and if you want to try another. Thinking of you, waiting for those updates from the clinic is so hard!

[Sweet_Chilli10 in reply to Memacha]

Thank you for this reply. This gives me hope for future cycles. We will wait and see what they say tomorrow and ask the questions 🤞 Xxx

[EndowarriorIvf in reply to Memacha]

May I ask what is zymot? Please let me know

[Memacha in reply to EndowarriorIvf]

It’s a process for selecting the sperm to then be used in icsi

[Suki27]

Hi I found out mid cycle that my amh results (from a separate nhs and a different private clinic) were incorrect as I was responding poorly to the stims and it was much lower than previously thought especially as I'm considered "young". The clinic was able to alter my dose for the stims which helped a little. We ended up getting 5 eggs and 4 fertilised with icsi into day 5 embryos. We were very lucky but at the time I did focus on the numbers and feel disheartened but it only takes 1, as cliche as it sounds! Wishing you the best luck and sending lots love ❤️

[Sweet_Chilli10 in reply to Suki27]

Thanks for you reply 😊 Would you mind me asking what stims protocol you used when you had better results?

I have had fluctuations in my AMH levels. I initially had an AMH of 1.5pmol/l and an AFC of 7 when we started this journey and first found out I had a diminished ovarian reserve. I then made a huge amount of changes to my diet and lifestyle over 3 months and my AMH was repeated and came back at 4.0pmol/l before starting our cycle. I was quite disappointed to see only 4 follicles when we had our baseline scan, but again I know this can fluctuate. In between this I had my AMH tested with the NHS and that came back at 2.1pmol/l so it’s all over the place.

I know it only takes one, so thank you for your kind words and positivity ❤️ I was hoping we would have a least one but I’m not feeling very hopeful this time.

H x

[Suki27 in reply to Sweet_Chilli10]

So my initial dose was 150units of ovaleap once daily but they then pushed it to 300units. In terms of egg quantities it didn't really make that much difference as I still only ended up with 4 mature eggs that fertilised but the clinic said it was worth altering to see if it would help. I didnt realise amh fluctuates so much till they retested and explained that's why I was only getting so few eggs, I just assumed your results stayed the same for a little while atleast but nothings ever straight forward with fertility. Try and not focus on numbers (easier said that done I know!). Sending all the positive thoughts your way ❤️

[Woolooblue]

I had a similar experience to you; low amh, his sperm normal, only 3 eggs retrieved. 2 of mine were considered too mature and they did icsi on the 3rd. They said it didn't respond well to the process. Knowing my husband's sperm was normal I had been confused as to why they did icsi and I did feel like it was the wrong decision, but I understand that they are the experts and will be doing their best to produce the best outcome. I will discuss this with them when I go for my second round.

In the meantime, I've been working hard to improve my diet and have been more clued up on supplements, so hopefully I'll be able to get a better result next time!

[Lelo3479]

Hi Sweet_Chilli10,

I am sorry to hear your journey isn't going well so far 💐,

I believe they do ICSI for many positive reasons. So that there are none of the issues that come with thousands of sperm around an egg.

But it also comes with risks, such as if they don't inject far enough away from a certain point of the egg and also incase they damage it.

Such as incase the egg doesn't close in time and another gets through.

Or so they can choose a good looking sperm.

Or ensure only one sperm fertilise the egg.

I think there's other variables that occur with multiple sperm present around an egg.

I watched some episodes on YouTube the other day by Infertility TV, a US Dr that covers many areas of IVF, he only ever does ICSI.

That's where I learnt this information.

Best wishes for your next steps x

[-Cupcake]

Hello, sorry you're in this position, it's such a devastating phone call to receive - it happened in my second round and I was gutted (5 eggs injected with donor sperm, but none fertilised - a couple showed changes but hadn't fertilised by the next day). But what I will say is every round really is different, and I'm currently 9 weeks pregnant - I think when dealing with a lower numbers of eggs the chances of a total fertilisation failure are higher, because in most rounds a number of eggs won't fertilise, but it doesn't mean this will happen every time. Thinking of you. I had ICSI every time - initially I was going to have IVF, but the first round the donor sperm wasn't motile enough so they used ICSI, and they said once they've used ICSI once they tend to prefer to use it again - I don't really think there's much evidence standard IVF would have improved things.

[Sweet_Chilli10]

Thank you all for your replies and support. I took a few days to detach from the whole experience as its an emotional rollercoaster. We had the confirmation last Monday that fertilisation had not worked. One egg had shown signs of fertilisation after they left it that little longer, but it did not fertilise in the end.

This journey is so difficult but all the positive stories do give me hope. I have worked so hard the past few months, changing diet and lifestyle, taking supplements, lots of walking, reducing stress - you name it and I have done it but this is totally out of your control. My initial scan showed a AFC of 7 and at that time my AMH was 1.5! By the time of starting this round of IVF my AMH had gone up to 4 however I only had a AFC of 4 so I believe when they say every cycle is different and we have to try not to focus on the numbers.

Going to have a little break now before the next cycle and just keep doing what I have been doing.

H x