Slow developing blastocysts, never have any to freeze - are there any other approaches we can try?

[clevernoggin]

Hello all,

We've just had a third failed fresh cycle. Each time our embryos are too slow at developing to be frozen, so we only get one shot each cycle by transferring the two most developed embryos and the rest get binned on day 6.

We did try adding in AOA this time but it didn't seem to make any difference to the growth rate. On our second cycle we did get pregnant, up to 8 weeks, but sadly it ended it there.

The clinic hasn't got any other suggestions besides just going again. A fortune and lots of pain for one roll of the dice. I have low AMH, low AFC, age 42 now. Wondering if anybody else has had a similar situation and discovered other better approaches? Perhaps abroad? I've heard vaguely of lower stim cycles that harvest fewer eggs which are better quality as they aren't damaged by the stimming drugs.

I'd love to hear ideas, suggestions, and personal experiences as we're feeling stuck right now and time isn't on our side..... Thank you x

[ellebee123123123]

Have they tried icsi piezo? i don't think this is offered by all clinics

[clevernoggin in reply to ellebee123123123]

I haven't heard of this (and the clinic havent mentioned it either) - so this gives me something to look into, thank you! x

[Alexie07]

I’m in a similar situation (40 and low amh and afc) and about to start ovulation induction. I’ve done 4 unsuccessful cycles of ivf this year. I have 3 kids but had my third at 36. I’ve had 2 miscarriages and 3 chemicals quite recently (3 chemicals this year)

[clevernoggin in reply to Alexie07]

Very sorry to hear of your recent experiences, wishing you all the best with your treatment. I will look into ovulation induction too, thank you for mentioning it x

[Alexie07 in reply to clevernoggin]

No worries. It basically means they give you the medication to grow more follicles and help their growth but you try naturally. Only costs a few hundred dollars where I am. Really only suited for those with lower amh/afc though as they won’t let you proceed if you have too many follicles for risk of multiple births

[clevernoggin in reply to Alexie07]

That's interesting, and feels like something we shold be doing in the meantime while we are deciding on the next IVF steps! I have a niggling thought that I can't let go of related to progesterone (or insufficiency of it in luteal phase). Feels like these two things could be combined to support otherwise natural tries..... Thanks again, this is really helpful for me to explore x

[Alexie07 in reply to clevernoggin]

Yes they give you progesterone medication and do regular blood tests and scans. Good luck!

[GenevieveOrange]

I’m so sorry you’re going through this. I don’t have the answers, but I’m in a very similar situation. I’m 39 with low AMH and AFC. I’ve done six cycles and had two miscarriages. I’ve never been able to freeze anything, but the two times I had a decent blastocyst, it resulted in pregnancies I sadly lost.

Next week I’m having a laparoscopy and hysteroscopy soon to see if anything comes up (I don’t have symptoms beyond infertility). I’m also trying ovarian PRP—feedback on it is very mixed, but some say it increases the number of blastocysts. I also wonder if high hormone doses might damage eggs. Like you, I’ve read that lower doses can work better. The two times I had better results, I started on a lower dose and stimulated longer. My FS, however, believes higher dosages don’t affect egg quality.

Sending you strength—it’s such a tough journey.

[clevernoggin in reply to GenevieveOrange]

Thank you for your reply GenevieveOrange. Hmm I don't think PRP is available in the UK (?) but I will now research it! I wish you all the best in your journey, and fingers crossed your test results are helpful, one way or another, to you getting a good outcome x

[Passby2024]

Hi, I have been following a Facebook group (search “the “Bourke” IVF protocol”) that is dedicated to increasing numbers of euploids of each cycle. I don’t plan to test my embryos but I have tried some of their approaches and my D3 embryos quantity & quality have both improved in my recent cycle #6 - I have got 5 grade 1-2 day 3 embryos and that’s as many as I have got from all previous 5 cycles combined. This cycle I have also switched to a new overseas clinic and I think their medication and lab quality have helped as well. On top of all that, I have used red light therapy this cycle and that seems to make a difference as well. For my new cycle, I plan to continue with all the changes, and add Giga Laser which people have reported good results on in some other Facebook group. Hope it helps.

[clevernoggin in reply to Passby2024]

This is really interesting and you've given me lots to go and look into! Would it be ok if I message you separately to ask about how you selected your overseas clininc and which one you are with? Wishing you all the best with this cycle - your stats definitely sound positive this time! x

[Passby2024 in reply to clevernoggin]

Yes of course.

[Happy_face]

Hi sorry to hear. IVF treatment is a hit or miss. When I began my first round of IVF treatment using ICSI, the results were not great resulting in 1 embryo which didn't stick unfortunately. The second time around were pushed for PiCSi treatment which resulted in achieving top quality embryos on day 5. I purchased the book 'it starts with an egg' and followed some useful tips and advice about certain vitamins to take to help boost egg quality, following a Mediterranean diet and avoiding certain chemicals . It's a good read and definitely worth purchasing.

Best of luck.

[clevernoggin in reply to Happy_face]

Thank you happyface. I am a disciple of ISWTE! Have been on Ovum the last two cycles and a few others so I basically rattle with pills now before I even start injections..... Cutting out environmental toxins seems darn near impossible though! I'm vegan but am tempted to consider eating eggs if it might help... I will look into this PiCSi option as it hasn't been mentioned by our clinic at all. Good luck with your journey too x

[Bluebell321]

Hi I don’t claim to be an expert but have you also looked at sperm quality including DNA fragmentation?

[clevernoggin in reply to Bluebell321]

Hi Bluebell, I don't think so. We have had the addon where they make the sperm swim through a sieve to select them, and 2 cycles of ICSI, but I don't think sperm frag has been tested or offered. My partner is in his late 40s but been taking Impryl since before we started, for what its worth. I will look into this too - thank you! x

[soccerkt6 in reply to clevernoggin]

Hi lovely, I second the suggestion about having your partner do the test for DNA frag. If it comes back high you should see a urologist who specialises in male fertility, as there may be a relatively simple, fixable problem (like varicocele or infection in the urinary tract) that's compromising his sperm quality.

[clevernoggin in reply to soccerkt6]

Wow ok, thank you! Yes that seems to be emerging from a few folk in this thread now. gosh it really puts a different dimension on how I've been thinking (worrying) about things. This is really helpful, thank you for commenting x

[Vassi]

I had a terrible 2 cycles before my last with poor fertilisation and resulting in nothing to freeze, then on my last cycle we did icsi with zymot and mechanical egg activation and we got a much higher fertilisation and two good quality blasts. There is positive stories about calcium ioniphore and I know someone who had success with this after many many failures. All the best with next cycle xx

[clevernoggin in reply to Vassi]

Thanks for your reply Vassi, that's really helpful to hear. We have done ICSI with Zymot, and most recently with AOA (I think this is the same thing as calcium / egg activation?). I guess its always a roll of the dice so perhaps another cycle might work out better for us. It would be great to have more than 1 chance from each stim cycle though! Best of luck for your 2 blasts x

[Vassi in reply to clevernoggin]

Oh sorry I wasn't sure what AOA was. I know exactly where your coming from and how difficult it is. Sadly I just had a chemical so it's also back to the drawing board for us too. I am taking a small break and really going to focus on improving egg quality. Has your protocol been the same each time? I did try mild stimulation once and didn't have a good outcome, not to say you won't, but I was advised against it by my clinic and I pushed for it, an expensive lesson learnt. I also found that my amh went up I believe due to the supplements xx

[clevernoggin in reply to Vassi]

I'm so sorry to hear that Vassi, that is incredibly hard and I hope you are finding ways to process this outcome and comfort around you. Taking a break to focus on egg quality sounds like a really good plan. For me, yes, the level of stim was highest on my 1st go (think it was the top dose possible), then lowered a bit for the next 2 goes, which produed more eggs and better embryo development. My AMH was lowest during my first cycle and creeped up a bit since then too. I don't know how much its supposed to fluctuate normally or if that's related to vitamins and better general health overall..... xx

[Vassi in reply to clevernoggin]

Thank you, I hope you get some answers and clarity on your next steps and wishing you best of luck for the next one ❤️

[TopGuntastic]

Sorry to hear of your experience, it’s tough.

I’ve recently used a pre treatment cycle of Testogel and had two back to back stimulations afterwards. My embryo quality improved from the previous round without pre treatment cycle. Might be something to ask your clinic about.

Do you know if the slow development is from fertilisation or if from day 3? I’ve read development to day 3 is based on the egg quality, while day 3-5 is more likely the sperm. What’s your partner’s sperm like? Is there MFI? You only mention your AMH etc.

Are you both taking multivitamins and has your partner significantly reduced and better still stopped drinking alcohol (if he does)? My husband improved his sperm significantly with consistently taking Wellman Conception Max and CoQ10, and having no alcohol for 6 months.

Other ideas might be to have Karyotype testing for you both to check there isn’t anything chromosomonal and dna fragmentation for your partner.

Editing to add that I’m also now with a Spanish clinic that is very thorough - both the male and female testing - and specialises in low ovarian reserve. Happy you private message me for details is helpful.

✨

[clevernoggin in reply to TopGuntastic]

Thanks so much for this TopGuntastic! There are so many things for me to look into - I liteally haven't heard of Testogel, MFI, Karotype testing.....so I have a lot to read up on! The clinic didn't say when the slowness occured, but I think it would be after day 3 as they always seem to do cell division then not quite make full blastocyst for freezing so this gives me something to ask them about! Thank you for mentioning about Spain. I'll pop you a PM if that's ok xx

[Lamagarden]

Hello, I’m 43 and have had a similar situation. Following 8 (!) rounds, that’s 8 ECs we only ever had 2 blastocysts to freeze the other rounds we put back the two that made it to day 5/6 and on 2 rounds nothing survived! We’ve had 3 miscarriages and several BFNs. No advice I’m afraid just this journey can be long and is painful. We are now considering DEs as I don’t think there is any point to keep going with my OEs. Wishing you all the best and lots of strength x

[clevernoggin in reply to Lamagarden]

Oh gosh that is a lot for you to go through Lamagarden! It sounds like a very long and painful journey you've been on, but I'm so glad that you feel there could be a good outcome for you with DE. I have no advice to offer in return, but thank you for your kind words, and I wish you all the best too - truly hope you succeed in this new stage xx