Total fertilisation failure

[BlueBirdy]

Hello,

My husband and I have just gone through our first IVF (with ICSI - we have male factor issues - bad count and morph, motility is ok). At my final scan I was only showing 8 follicles (was on 150 units gonal f) 6 were a good size but two were smaller ones. I thought this was on the low side but the FC said they were happy with how I responded and pleased with the amount of follicles. Had pregnyl 1000 trigger shot on Saturday and went for egg collection yesterday (Monday). They collected 7 eggs but only 6 were mature. Got a call yesterday eve to say that of the 6 they injected, 2 didn't respond very well, so was usually an indication that those two did not have the best chance of fertilising, but overall there is a generally a 70% rate of fertilisation. Got a call this morning to say that sadly NONE had fertilised. They said this was very rare (I later googled it and apparently there is a 1 - 3% chance of it happening with ICSI) and said they could not tell why it happened (or rather, didn't happen) but could be down to either the sperm or eggs or drug regime I was on. I'm really gutted. This was our one and only NHS funded cycle.

I've got a follow up appointment on Thursday morning, not sure if I'll find out anymore then. Was just wondering if anyone else has experienced this, and if they had any success with further cycles?

Okay Blue. Just had a read of that 2nd link you posted. Very interesting that she used two different triggers - Ovidrel the first two IVFs where she had 19 follicles over the 2 IVF's but only 4 eggs total - all immature. Then this Dr changed the trigger to Pregnyl and she got 7 mature eggs.

I know you used Pregnyl the first time (as I remember your saga with the short needle that didn't fit to the end of the vial!) but what trigger did you use this time? Perhaps that is the difference for you too?

Sorry, hopefully I am not stressing you out. Either way you have two embryos inside you now that are hopefully making a nice home. But with my IVF still ahead, it just has me curious and wanting to do the right thing for my IVF, so that's why I'm curious what trigger you used.

Serenity, I too am thumb twiddling. I start estrogen on day 20 of my next cycle in prep for IVF the following cycle. Hopefully they don't keep you waiting too much longer after your appointment. By the way, when you say you've moved to a bulk billing clinic, how much out of pocket will you be at the end of a cycle? The Fertility Centre in Melbourne was cheaper but I was still out of pocket over $2000. I've heard interstate is cheaper than Melbourne - perhaps a holiday to QLD would be lovely while doing IVF and help it work!

Shellster I think it's $3000 all together and in the end I'm out of pocket $990.

Shell I used 250 Ovitrelle (Ovidrel) I know the doctors/fertility experts at the FC will hate this, but I'm going to print that page out and take it with me to my next appointment!! Did you mention that in this next cycle you'll be including the LH later on than usual? Is that what the article means, do you think?

How is everyone's thumb twiddling going? I'm sooo bored. And having a sack of cement for a tummy doesn't make things fun, either.

Yes, I always go in with my online studies and think the Dr's must be sick of us Dr Googling. But no harm to ask the question. On the up side, you did have two fertilise this time so something went better in that department with your different protocol.

Yes, I will be taking LH later in the cycle - when the lead follicles get to around 13mm I think if I remember correctly. My Dr said this mimics what happens in a natural cycle. That article seemed to suggest avoid LH right through the cycle rather than just at the start of the cycle. I am not sure of the difference between Ovidrelle and Pregnyl. Does Ovidrelle contain LH and Pregnyl doesn't? Surely in IVF we must still need LH at some point as this rises towards ovulation in a natural cycle and is responsible for the egg maturing and causing us to ovulate. So it seems that some LH is crucial as part of the egg development. We are not yet over 40 like the woman in that article - and you have a fantastic response to the meds so I don't think you have diminished ovarian reserve and an excess of LH in your system like other older ladies. Perhaps just the Pregnyl trigger works better for you? You seemed to get a better response with Pregnyl, this article seems to suggest Pregnyl and my Dr wants me to use Pregnyl, so I am happy with that decision.

I hope it all doesn't matter in a few days time when you get a BFP and can forget this.

I have learnt more from you two and this thread then from anyone else.
Thank you!

Serenity, I missed you 2nd last post that you are only out of pocket $990! That's incredible. I am out of pocket $5500 with Monash IVF! I have just booked a holiday to QLD to get away from babies and pregnancies at Christmas here in Victoria, had a car accident and am planning on doing IVF in Dec before my holiday as I will get a higher Medicare rebate before the new year. Has me very stressed about the money. Your $990 figure has me seriously considering if I should make a last minute switch of clinics.

Do you think your cycle will be compromised in any way at this cheaper clinic? Can you see any place they are cutting costs that could jeopardize your potential BFP? Is there a valid reason Monash is so much more expensive?

Blue, how are you holding up? I've purposely tried to lose track of time with all this as I was going insane counting the days til my next IVF. While I have successfully done this, I have also lost track of your timeline. How many days post egg collection are you now?

Me again Blue.
You've really got me thinking how I can do my next IVF cheaper with your $990 figure.
I just looked up QLD Fertiilty Groups affiliated clinic in Victoria.
Unfortunately, the clinic here is a lot more expensive.
I was told on the phone it will be $3800 out of pocket.
But I just looked on their website and on top of the $3800, you also have to pay:
$910 for egg collection
$432 for embryo transfer
$300 anaesthetic
which adds up to about the same price as my current clinic.

So I tried to find your clinic online as if I was only out of pocket $990, then it would still be cheaper even if I flew interstate.

Is this your clinic I found online?
It states here that I would be out of pocket $2910 for ICSI - not the $990.
Have I looked up the wrong clinic?

Shell
These are the payments which are staggered.
Initial consult - $295
Drugs - $940
Transfer - $1683
ICSI - $200

Make claim to Medicare

Out of pocket approx $900

This is straight from their paperwork.

Everything is nurse led. You see the doctor maybe twice.
Egg pickup is under a local not general.
You don't see the sane person every time.
Everything is bulk billed.
Oh the doctors and nurses rotate through from the QFG office.
They put you on the pill so you fit into their schedule not them into yours.
Freezing is more expensive.

Success rates are pretty much the same as everywhere else.

Hey Serenity - glad this thread has helped you so far! Group knowledge is really indispensable :)

Hey Shell - had retrieval a week ago! Seems longer than that! I'm currently 5DP2DT (I think that's how you say it?) Another week and 2 days before I should test. At least I'm not in constant pain anymore - I haven't needed to take painkillers for 2 days now! I'm still quite bloated, though. Apparently OHSS can 'yo-yo' though, so it may come back again. Pregnancy makes it worse so if it gets bad again it may be a good sign! Hope you can sort out cheaper IVF for yourself!!

That really is cheap Serenity.
So is that link I provided above for a different clinic to the one you attend as that link says the out of pocket cost is $2910.
Could you provide me with the exact name and address of your clinic or a website link or a phone number so I can inquire about having treatment there myself.
I think I will stick to Monash for my one last attempt as I have seen the Dr and have a plan in place that I am happy with.
But I can't afford to keep doing it at $5500 a go so it would take some pressure off this cycle having to work if I have a back up plan.

So it's only been 7 days then Blue.
It even feels longer to me so time must really be dragging for you.
I remember being there and madly trying to symptom spot to see if I could feel implantation.
Guess you've been too distracted by the pain.
Can't believe you've had to take painkillers for 5 days.
Glad you're feeling better.

Shell the link is for the parent company. This is the cheap clinic.
thefertilitycentre.com.au/springwood/

Thanks so much Serenity.
That website style is exactly the same as the 'The Fertility Centre' here in Victoria where I attended last year so they must be affiliated.

But even the Fertility Centre isn't as cheap as your clinic.
I shall ring them and ask them if they do certain things that I require for my treatment.
Thanks again.

Blue, how are you coping.

One week down, one week to go. Starting to get the same sort of pains I get a week before I normally start AF, so a bit worried. Trying to stay positive, or at least to forget about it, which is of course difficult.

Wow, another whole week.
This just seems to be taking forever - even for me.
Must be going glacial slow for you.
Do you normally get pains a whole week before your period is due?
With two transferred, surely at least one would be burrowing in... perhaps that is what the pain is.
Yep, forgetting is difficult, hopefully you can at least stay positive.

Yeh, I normally get bad pains a week before AF - actually I normally have pains on/off throughout my whole cycle, but the week before is normally quite bad. Having bad cramps at the moment too. I've previously had scans to look for endo, but came back clear. Boobs are not at all tender/full which I would assume would be a good pg sign. I know being on cyclogest and progynova will be doing all sorts to my body, so probably not that reliable to symptom-spot anyway. My EC was a monday, so assuming that would be 'ovulation', then I'd be due AF on Tues (although I'm sure my cycle will be a bit off from all the drugs). OTD is Weds, but I can't help but feel like it's not worked. Think I'm not going to test on Weds, maybe I will on Thurs as I'm back to work from tomorrow but have Thursday off. I already feel like I'm anxious for my next round of IVF to start.

Hope you're doing ok!

Bluebirdy i seem to have similar fertilisation issues.
Ivf#1. 32
10 egg
7 mature
1 fert
1 atypical
1*20, others smaller
Implanted 1 8?cell a/b and an atypical =bfp
Ivf#2 34
9 eggs
4 matture
2 fert
Plus 1 abnormal 3pn
Follicles: 218,315
Implanted 1 6cell b/c, 1 8cell b=bfn
Ivf stimm
3 eggs grew cancelled

Ivf#3 35
13
12
8 fert
4 atypical
Follicles 420,218 total 30+
Implanted 1 8cell a/b 1 10cella/b
Other embryos arrested 2 >6cell

1&2). Long protocol, pill, buruselin spray, menopur 75/150 alt days ovitrel
3) change to gonal f 150 daily coasted 2 days before trigger

I think my smaller follicles dont fertilise/are immature.
I only get a couple of large eggs.
Maybe i need to step down dose start high to get them growing but then sizes would be very different.
I get better embryos from larger eggs.

We have severe male factor

How are you holding up Blue?
I can totally imagine you naturally preparing for your next IVF.

I think it's your minds way of protecting itself as you would be so scared this has failed. So you naturally come up with a plan B so that you don't have so hard to fall in case this doesn't work.
I know your official test date is Wed, but today is two weeks since EC (at least it's Monday here in Aust - I think you are about 11 hours behind).
So I would think if your period hasn't showed up by now, it's a great sign.
Sounds like a good idea to test Thu when you have a day off.

Oh, and yes I'm doing okay thanks.
Today is day 2 of my cycle so I start oestrogen pills on day 20 in prep for IVF next cycle.
So my turn back on the emotional roller coaster of IVF is coming around.
I am REALLY wanting to do high protein low carb diet this month in the lead up. I am so good all day but a little monster in me comes out at night and I just want to pick at all sorts of bad food. Must somehow stop so I have no regrets with next cycle.

Hi Naty - yes, very similar! So what was the outcome of IVF#3? Or are you also on the 2WW? Yes - wish they could find out where it was all going wrong! But if there is one thing I have learnt, it's that if your clinic doesn't offer it, then they won't mention it! I've read so many times how the clinic says the only option is donor egg/sperm, when really there are other ways to make it work - and yet they are so quick to effectively deny you a child that is genetically yours! Such an important factor for so many! For our next IVF/ICSI cycle, I'll ask about chromosomal testing of the embryos, and if they don't offer it, I'll find a clinic that does.

Hi Shell - that's exactly it - a plan B to soften the blow. To be honest, even if if miraculously get a BFP, I won't be able to appreciate it until I see a heartbeat at the scan stage, if it ever gets that far. (And even then, I think I'll always be too worried that something will go wrong to ever fully enjoy a pregnancy). Good luck with the diet, and have all my fingers and toes crossed for this cycle of yours!!

On an embryo quality note, have either of you tried DHEA (or something like that) - it's supposed to improve egg quality, and as that may be an issue of ours, I'm thinking of trying it for the next cycle.

Otherwise, I've always been prone to dizzy spells, and yesterday and today I felt quite dizzy. Not nauseous, just dizzy, and I'm kicking myself for letting this get my hopes up! Grrr, only 3 more mornings until I test, unless of course AF turns up before then!

Yes 2ww. 4dp3dt.
I had spotting from 12dpo (9dp3dt) on failed one so hoping to get past there.
I think im missing 2 cyclogest so now i have to sort that with clinic. Not much good if id noticed when reached the last one. Though should think the last day, 15dpo probably doesnt matter too much as i seem to be able to get cycle anyway. Not supposed to test till day 16.
They definitely should give impartial advice to refer to another clinic if the offer something they dont.
Its so generic i dont feel they optomise chances as seems like 90% go on the same protocol. Always scans alternate days. 36h to collection.

Blue, somehow I really am just feeling BFP vibes for you.
It's over two weeks since egg collection and no sign of your period.
That's a big indication to me right there!
Wouldn't your period normally have shown up by now?

Yes, I've tried DHEA.
I took it based on this study
But I've been doing IVF and taking DHEA on and off since last year now so not sure if I'm overdosing on the stuff!?!

Shell I'm taking a concoction (when i remember) too.
Pregnenolonr
L-arginine
L- ornithine
Coq10
Plus the Elevit
I rattle

Have you got your chromosome tests back *Serenity"?
Any dates in place?

The ant is tomorrow so we find out everything tomorrow.