Do I need extra tests?

[patientlywaiting1234]

Hi all,

So my second ICSI cycle has failed and I am gutted. On the first round, we transferred one top quality blast and were given a 65% chance of success. We didn't get any frozens- the nurse said my clinic has very strict freezing criteria. This cycle was pretty much the same- a top quality blast, 65% chance and no frozens.

I was surprised by the high odds and obviously got my hopes up each time. I'm very anxious now, thinking that either we are just really unlucky or we need more tests. We have male factor infertility- my husband has a blockage so we extracted sperm and there doesn't appear to be anything wrong with it.

Have any of you been in a similar situation and have extra tests? If so, which ones?

Thanks all

Difficult to tell whether the issue might be embryo quality or implantation. I had ICSI for male factor infertility but then found egg quality issues too. Can I ask how many eggs were collected/fertilised in each cycle, and what the sperm analysis results were?

Thanks for replying, Blue.

In the first cycle, we got 6 eggs and 4 fertilised. Three became blasts on day 5 and we transferred 1 top quality one. My clinic have very strict freezing guidelines, so didn't freeze the other two as they only freeze absolute top quality blasts. The other two were good quality, but not top.

In the second cycle, they upped my dose of stims drugs and we got 9 eggs. 6 fertilised, three became blasts. Two top quality embryos implanted (can't believe they let me at 32) and the other wasn't top quality so wasn't frozen.

Husband has a blockage and all we've been told about the surgically extracted sample was that 'not all of the sperm were motile, but that's nothing to worry about as the embryologists picks the best ones that are motile'- exact words.

Who knows eh?

Thanks again and good luck to you if you are going through a cycle or due to soon. How many have you had so far?

I am surprised at the clinics stance on only freezing 'top quality' embryos - they can only tell how good they look, and not whether they are genetically normal. I've been reading on here about genetic screening, and highest graded embryos can be abnormal and lower graded but still good embryos can be genetically perfect. Don't know whether this is at all relevant in your situation but maybe something to consider. You got a good number of eggs and fertilisation rate. ICSI picks out the best sperm and you had good number fertilised, so sounds like that side things is ok.

It could be that the embryos were fine but there was an issue with implantation. Have your clinic given any indication of what they think happened and what you might do differently? What are your plans?

I am currently in the middle of my third ICSI cycle. In my first (NHS) cycle, I had 13 eggs, of which 7 were mature, 5 fertilised, no blastocysts 😱 I had 2 put back anyway but it was never going to work. The second (private) cycle, I had 24 eggs, of which 9 were mature, 6 fertilised, 3 blastocysts. I had 2 put back in and they both implanted so I was pregnant! Sadly we lost one at 5-6wks, and then devastatingly I had a second trimester loss at 21wks when my son was born early due to a cervix condition I didn't know I had. It can be treated in any future pregnancy so we are now trying again. I'm on day 9 of stims with egg collection hopefully early next week.

I would be bloody pissed off that the clinic wouldn't freeze any left

Yes a good embryo stands a better chance but have also read stories of day 3 poor quality working

Happened to my friend - had 2 left at day 3. Said too poor to blast and told her not L likely won't implant

They are now 11yr twins who started secondary school

Always worth freezing imo if any left over

I think you need a second opinion at a different clinic which can do imse if they think necessary. My not top quality frozen blast is 18months old... (my best "perfect" blast was from a fresh cycle and resulted in a missed miscarriage).

Thanks for the replies, everyone. I was quite surprised at the strict freezing criteria but they justified as 'better to only freeze the top quality ones and get a 98% thaw survival rate than have to tell someone their embryos didn't survive'. This was in the embryo transfer room and I had my legs in the air about to have two blastocysts transferred so I didn't really question it!

With hindsight, another odd thing that happened was the embryologist really pushed us to transfer two blasts, both 'good quality'. I was surprised as I think usually it is recommended to just transfer one if under 35 (I'm 32). I asked the embryologists whether it would be better to freeze the second blast to try again if this cycle failed and she said our best chance of the slightly less good quality blast leading to a baby would be to transfer both. Now I think about it, that's a bit odd isn't it? Particularly given that the overall pregnancy rate for two transferred embryos is only about 5% higher than with one (so they told me anyway).

Blue- you sound like you've had a really tough time and I really feel for you. I have my fingers crossed for you for this next cycle xx

Thank you patiently. I only transferred two because they were not top quality - one was a 3BC and the other was a captivating morula (pre-blast). One of them became my son who was genetically and physically perfect. So I'm surprised that they transferred 2 in your case, with your age and blast quality taken into account. I think you need to ask some tough questions. Is there the opportunity to move to another clinic?

Thanks for replying, Blue. Yes, we're transferring to a new clinic as we've used up our two NHS goes. Hopefully we'll have more success with them. When I next speak to my current clinic, I will ask those questions, though, as it just doesn't sound right to me...

I only had one NHS cycle, and I could have had frozen cycles but as I had no frosties that was out. Make sure you get a copy of all of your notes (you might need to pay a nominal amount but it will save time and money with the private clinic not needing to repeat tests etc).