1st IVF BFN, Age 40, low fertilisation, any tests or recommendations?

[SKC111]

Hello, I have just finished my 2ww, it was a BFN after our first cycle. We have two more cycles so I’m looking for any recommendations or tests that might help our us make improvements.

In summary (11 AMH in Sept 23 & AFC 21) this dropped to AFC 11 before EC Aug 24 unsure current AMH. I had 8 eggs collected, 2 fertilised, double transfer at day 3. Embryos had 50% fragmentation.

My partner had a test which showed 1% morphology at EC 8 months later this improved to 14%. He already has two children. He has a very stressful job. If it’s male factor we would consider using sperm donor, what tests are best?

I’m already considering donor eggs and I’m open to this if my own fail.

Thank you in advance for taking the time to read my post and for any recommendations you may share 🙏🏻

[DianeArnold Partner Nurse Fertility Network UK]

Hi. Your blood results etc aren’t too bad at all, so maybe a different protocol may help. Ensure your Fallopian tubes are not blocked or scarred, so any leaky fluid can’t interfere with implantation. Perhaps a hysteroscopy if not done, to check out your womb and biopsy the lining. Keep your support around you and good luck next time. Diane

[SKC111 in reply to DianeArnold]

Thanks, Diane. I was going to discuss with them changing my protocol. I was on short but want to see if they advise if long may be better. I had my tubes checked last year and it was all clear, I haven’t had a hysteroscopy so will look into this, I saw one clinic charge £2100. Thanks again for the reply it’s greatly appreciated xxx

[Lelo3479]

So sorry to hear this 😔❤️🙏

[SKC111 in reply to Lelo3479]

Thank you. Wishing you all the best for your test day xxx

[-Cupcake]

Hello, I am a similar age with similar numbers to you, and I'm currently 11 weeks pregnant after my 3rd round, so there's absolutely still hope for you! (I used donor sperm as I'm hoping to be a solo mum). As I understand it, at our age you tend to need quite a few more eggs, and therefore on average a few rounds, to get enough that are of good enough quality to make it - I read that a young woman has about 80% good quality eggs and 20% poor, whereas for an older woman it flips to 20% good quality and 80% poor. So sometimes it really is just a numbers game (if your bank balance can stretch that far). If you're open to donor sperm, you can always try a round with a donor that has proven fertility, and see if it makes any difference? At least that way you'll know more before thinking about the move to donor eggs. I did do long protocol in all 3 on my rounds.

[SKC111 in reply to -Cupcake]

Thank you for taking the time to reply, this is really helpful. I’m going to see if I can have long protocol next time as most people I’ve spoken to with a similar age/results took this route and had better results. We fortunately purchased a 3 cycle package, I am concerned tho that my partner has just turned 42 so both our quality together may not be the best combo he has a busy few months with work coming up so can’t control his stress, he would rather wait a few months but given my age I’d rather go sooner. I think if these three fail we will look a SD route as you say select someone with proven success before we looks a DE. Thanks again xxx

[SKC111 in reply to -Cupcake]

I forgot to say congrats on your pregnancy!!!! Wishing you all the best 🧡 x x x

[IVFat40]

I found the book 'it starts with the egg' by Rebecca Fett helpful for improving egg quality at 40, the book is quite full on so don't panic if you can't do everything, but the advice/knowledge is helpful especially regarding supplements to take. I also saw good improvements after seeing a fertility nutritionist and having a diet overhaul (all changes ideally need to start at least 3-4 months before an egg collection). My son came from my 3rd egg collection. All the best of luck.

[SKC111 in reply to IVFat40]

Thank you for the reply & recommendation ! I have read her book, I made a number of changes. I think I’ll revisit it. The one thing I might start is taking DHEA I have some at home but haven’t had my bloods taken so will see if my clinic can do this. It seems 3 is the magic number 🤞🏼🤞🏼🤞🏼 congrats on your son xxx

[IVFat40 in reply to SKC111]

Thank you!I took DHEA (50 instead of 75), and do think it helped.

[SKC111 in reply to IVFat40]

Great, thanks. I’m going to give 50 a go too x

[Gofly84]

Hi. I just wanted to give some reassurance after your first cycle. We have had 4 cycles and have learnt different things through each. In the last one, our consultant put us on a long protocol to ensure the follicles grew at a more steady rate together which did lead to more eggs and embryos and we had 5 embryos frozen eventually - we decided not to do a transfer as wanted to endometrium implantation investigations. This cycle was better than our last two which were short cycle and similar to our first one which was long. Our consultant also gave us max stimulation- I think a mix of ovaleap and Menopur 450 iu total. This was higher than our previous cycles. Also try acupuncture if you haven’t already? I got acupuncture leading up and during stimulation and I feel it had a significant impact, even the consultant recommended us to go for it so there is good evidence for the benefits of acupuncture. Hope that helps and wishing you all the best x

[SKC111 in reply to Gofly84]

Thank you for your reply! It’s good to hear you have been able to improve your cycles & another example of better results with a long protocol! What endometrium implantation investigations did you have? I have booked in for some accunpture with a highly recommend fertility specialist, I’m looking forward to this! Thanks again x

[Gofly84 in reply to SKC111]

Hey there. It’s the dEFT test, you can find more information here- warwick.ac.uk/fac/sci/med/r...

Unfortunately we will need to repeat the test as we had done it after an egg collection cycle and the results were way off the chart, they think better to try in a normal cycle 🤷🏻‍♀️😞

There’s other endometrium tests like looking at the micro biome but we’ve not gone for that yet.

Hope the acupuncture helps and all the best x

[SKC111 in reply to Gofly84]

Amazing thank you! I have just emailed them 🙏🏻 xxxx