Advice needed on next steps

[Sevla30]

My Fiancé (34M) and I (34F) have been trying to get pregnant for 3 years (we were not specifically trying for about 8 months before that but without monitoring ovulation or anything like that). We had our first appt. with the GP about our fertility in March 23, and in October 2023 we had our first appt. with a fertility specialist who after looking at all our tests did a laparoscopy procedure and gave me letrozole to take. I took letrozole for 6 months (without success- although it did help regulate my cycle) and had a review with my fertility consultant in July 2024. It was then decided that IVF would be our best bet and we started our first round of IVF in October 24. That round I was taking 225iu of meriofert for 5 days, before starting 0.25mg fyremadel and after after 12 days of stim injections 2 x 5000iu zivafert as my trigger shot. In the round we collected 17 eggs of which 15 were mature and only 5 fertilised, 3 made it to day 3 and 1 made it to day 5 (5AA) and was transferred. Sadly the transfer failed and we started our second round in Jan 25. Our second round was very similar in protocol as our first round, but with a higher dose of meriofert (300iu) and using ICSI rather than IVF. Again I was stimulated for 12 days and at my collection we retrieved 16 eggs, 11 of which were mature, 8 fertilised (using ICSI) and 6 made it to day 3. Unfortunately none of the embryos made it to day 5 this time and so we were unable to transfer.

Our consultant told us that our only option now is embryo donation. The embryologist suggested PICSI first and then embryo donation if the PICSI doesn't work. Has anyone else experienced something similar. Is embryo donation really our only option here. I would love some outside perspectives. It just seemed so drastic when we got one good quality embryo in our first round, but maybe I need a reality check.

Information to note: Some of my partners sperm looked to have some issues with motility and shape and my eggs were quite sensitive to ICSI e.g. a couple didn't survive the injection and one was noted to have a weak barrier membrane. Our fertility issues are still classed as unexplained although it is thought that there are problems with both the eggs and sperm.

We are both taking supplements (Proceive men and woman conception, Omega 3 and Vit D3 for me, I have recently (Dec 24) upped my dose of CoQ10 to 600mg and my partner is also taking Zinc and Magnesium and now CoQ10) and are being stricter with our diet.

[Jmfl]

Hi lovely,

I’m 35 and husband is 36 and we’ve been trying for over 2 years and have completed two egg retrievals due to male factor infertility. Based on our experience and several appointments with urologist/andrologist, my husband found out he has a varicocele our next step is to get the embolization done. We haven’t had a successful transfer yet but the doctor told us instead of 2-5 days of abstinence to try 12-18 hours on egg collection day. We had 3 day 5 blastocysts instead of 2 from the first egg retrieval. Both cycles were ICSI. Hope this helps xx

[Sevla30 in reply to Jmfl]

Thank you so much for your reply. I'll mention this to our consultant and embryologist and see if they would agree with this too! We possibly need to see a urologist/andrologist too. xx

[Tinkertinkerbell]

Hi, that is strange that they want to go to embryo donation so quickly. I had a baby 4 months ago through double donor - consultants never mentioned embryo donation. I did 2 rounds with my own eggs without getting any good quality blastocysts and I’m a lot older than you - if I was younger and had got a good quality blastocyst like you did first cycle, I would definitely try again with my own eggs once more! Then maybe get them PGTA tested? But the thing that worked for me in the end (because even the donor egg embryos didn’t work at first) was the EMA,Alice and ERA biopsy. For me it turned out the timing of my transfers had previously been wrong- they had all been put back too early. As soon as my timing was adjusted it worked! My 5th transfer resulted in my daughter now 4 months old. It could be something like that prevented your first transfer from working? Good luck x

[Dragonfly1111]

Hi Selva30, I just wanted to reach out as I am in a similar position - I am so so sorry as such a hard place to be and know there is no clear answer. Myself and partner are 32 and have had 3x cycles (1st total fert failure with ivf, 2nd icsi 50% fert but only 1x D6 FET in chemical, 3rd picsi only 1 egg fertilised didn’t make it past day 3). We have been told to move onto egg donor as think the problem is my eggs - we are waiting to get a 2nd opinion at the moment. I did a post a few weeks ago about moving onto donor and had lots of helpful replies if you want to take a look. Sorry again and inbox is open if you ever want to chat x