IVF/ICSI total fertilisation failure advice

[GingerFox88]

Hi guys, I’m just wondering if anyone has been through the same thing as me and could advice on next steps or even why this is happening.

I’m 35 and my husband is 42. We have recently had 3 failed rounds of IVF.

First round we did IVF and they collected 11 mature eggs. None fertilised and they said the sperm wasn’t showing any interest in the eggs. - they said some of the polar bodies on my eggs looked flat.

Second round we did ICSI and only 2 eggs collected, one fertilised and made it to day 3 then arrested.

Final cycle was ICSI again, 3 eggs collected, they damaged one when injecting and other two failed to fertilise. - they said the cell wall was quite hard.

They never changed the medication or dosage on any of the cycles.

All other tests have come back fine for both of us. They’re saying it’s egg quality and our only other option is egg donation.

Has anyone else been through anything similar? Or have any advice for us please?

Sorry to hear this. Given the disinterest of the sperm, is the issue definitely the eggs? Are all semen tests fine so far?

@sirensong thanks for responding. So the mobility and shape of the sperm all look good. They haven’t looked at anything else.

My fist round I had 29 eggs but only 1 that made it to blastocyst.

My second round we changed drugs. I had 24 eggs but 10 made it to blastocyst. I had 2 transfered and the rest frozen.

I got pregnant twice with twins both pregnancies ended in MMC. I had a few failed frozen cycles and then my final pregnancy ended in a singleton who is now 5.

I think changing drugs is a good idea. I also did intralipids in my successful pregnancy.

What clinic are you at OP? What are your AMH levels? I’m an acupuncturist with lots of IVF training and experience.

Additionally what supplements are you taking and are you upping protein intake whilst stimming?

It’s been a while, but I’d think they slightly overstimulated you before and under the next two times in reaction. Also, the eggs sound like they may have been damaged by the ICSI operator (which they’d never admit).

Would probably change clinics at this point, do two more cycles (frozen) before going to egg donation. That’s my personal feeling only.

EDITED to add I’ve just reread about being on the exact same protocol… so my over/under stims theory doesn’t work. I’d still be trying a new clinic because it seems a big jump to egg donation as really only a couple have been given a chance. Sounded like a sperm issue the first time

I would look at changing protocol first and trying that before anything else - i had similar poor results from my first 2 rounds and then changed protocol drastically and did go on to have success. I had to basically insist my clinic change protocol though

@Greatmate thats great news! Made me feel a little bit more hopeful so thank you. What are Intralipids?

@Nurber I’m at the Centre for Life in Newcastle. My AMH is 12.5 so not too bad I don’t think.
Ive taken prenatal and omega 3 throughout, and I’ve just started taken coq10, NAC, R-lipoic acid and myo-inositol. Feel like it’s supplement overload. But I following it starts with the egg. I have quite a healthy diet and eat a protein with every meal.

@RosieIs44 that was my thought too. They haven’t tried any different protocols. They advised egg donation after cycle 2, but I thought that was a big jump considering they only had two eggs to work with and one actually did fertilise if not only until day 3. I felt like they weren’t really bothered after that when we said we wanted to continue to try with my eggs. We’re looking at different clinics not. Possible the Hull and Reading clinic or Manchester Fertility.

@usererror99 what protocol did you change too?

thanks for responding guys. I’ve felt really low after the news but this has made me feel a little more hopeful xxx

Without going into huge details your clinic is below national average on almost everything that matters. Using the exact same protocol every time is not the key to success which you can see particularly in your case.

I would advise spending some time looking into different clinics. There are ones worth travelling to which alter medications daily depending on scans, although these are pricier. there is also lots more testing you can have done but would imagine this is not what your clinic is offering.

Also upping your protein intake in the weeks before and during the stimming process and including a protein shake can improve quality of your eggs.

Your AMH is on the lower side. When was the last time you had it tested? It may account for your lower egg numbers in round 2 and 3 which would indicate a need for increased stimulation, not a repeat of the protocol from round 1.

Definitely look into changing clinics. I know nothing about your issues or your clinic but looking at what Nurber has said above they might not be one of the best. I genuinely believe if we’d stayed with our original clinic we wouldn’t have a child. They just wanted to do the same thing over again and weren’t bothered about my hypothyroidism. The clinic we moved to tailored everything.

@Nurber ive looked on the HFEA website but I honestly find it so confusing. I honestly wish I’d asked to go to Gateshead Fertility Centre instead when I was referred. But I’d heard good things about the life centre.

The clinic advised against protein shakes because they said they can have a negative effect on fertility. Is there a particular protein power you would recommend?

I did a private AMH test 3 weeks ago and that was the result.

On the second cycle my left ovary just didn’t respond to the medication at all for some reason. They couldn’t give my any explanations for it!

They said I was on the max dose of medication for all 3 cycles. I took Buserelin, Menopur and Ovitrielle.

i have read though that after the first cycle your ovaries can sometimes not respond as well because they’re protecting themself. I don’t know if that’s the case because the clinic could never explain anything. I asked how I could improve egg quality and they simply said you can’t

@FlipperSkipper thats really positive to hear. I wish we’d changed earlier but that’s easy to say in hindsight I guess. We have a consultation with another clinic next week

It's like a fat infusion. A bit like intravenous mayonnaise 😂. It's soybean oil, egg phospholipids, and glycerine. It helps with immune suppression so your body doesn't attack the embryo.

I think first you need to change your drugs. My first round the eggs were not very good. I swapped drugs and it was much better the next time.

I've had 3 cycles of IVF. Low AMH and sperm issues, was 33 when I started.
1st and 2nd round were poor outcomes, 3 eggs/2 blasts and 2 eggs/1 blasts. Each of those rounds I took loads of supplements. High dose of stims on long protocol.

3rd round - vit d and pregnancy supplements only. Low dose of stims, short protocol - 6 eggs/5 blasts, one live birth.

I would push for a change in protocol or move clinics to one that will investigate prior to another egg collection. Have they given any reason why the eggs have a harder outter?

Also randomly, Asda pharmacy doesn't make profit on IVF medication. My clinic could dispense the drugs or provide a private prescription for free. Every drug except progesterone oil was cheaper at Asda. You do need to price it up but on some drugs Asda changed 8x less than my clinic. Getting the drugs at a more reasonable price meant we could keep on going. I had 2 fresh and 5 or 6 frozen cycles so it really did amount to big money.

It all starts with the egg is a great protocol. Stick with it!

there is one fairly small study which shows no difference with protein but the most private clinics recommend it. It’s about getting the right powder, none with articifical sweeteners and definitely no soy. Protein should be 60-100g a day. Some clinics recommend even more.

that’s great you’re going elsewhere for this consult. It may also be worth a phone consult with one of the big London centres who adjust daily for their ideas which you can then always talk to your clinic about afterwards. ARGC are divisive but are at the cutting edge.

good luck!

Try Low dose or natural ICSI high doses of stims wreck your eggs.

Low dose won’t work with someone who has low AMH. There is a balance to be found with stimulation, unless over stimulated, it doesn’t ’wreck your eggs’.

I changed to natural modified IVF with ICSI and my AMH was 12.4 - I then had twins on my next transfer

@GingerFox88
Hi I appreciate this is a late reply but now I've found myself trawling through Mumsnet after having a similar experience. I'm sorry to hear you've had similar heart breaking news.

I'm 30 with AMH of 5.4 and DH has slightly low morphology (3%). I've been taking COQ10 600mg for 6 months as advised.

Our first cycle was short protocol with high stims and ICSI I only got 1 over mature egg and had total fertilization failure (R ovary didn't respond)

Our second cycle was short protocol with high stims and ICSI only 3 mature eggs and again total fertilization failure.

We have basically been told they think there must be something wrong with my eggs and think there is a very high chance the last round won't work.

They are going to try a long protocol for the last round but we have basically been told not to expect anything different and won't add on anything like Artificial Oocyte Assistance.

We are going to look into mild IVF after that which focuses on egg quality rather than quantity but still don't have much hope.

Do you mind me asking if you've had any further cycles since your last post? Wishing you well x