Failed first round of ICSI, 1 frozen blast - WWYD next?

[AliciaWhiskers]

Our first round of ICSI hasn't worked. I didn't respond brilliantly to the meds - we got 5 follicles, 4 had mature eggs, 3 fertilised, we transferred 1 and had 1 frozen.

I'm 40 (with PCOS, and AMH of 13.3) and my partner (with MFI) is 44.

I'm worried that if we did a FET next, the blast might not survive thawing, and so we would have, in effect, "wasted" a couple of months with that cycle and then have to start again with a fresh cycle. I don't know if it's better to try another fresh cycle straight away (I know the cost is more, and we are self funding so this is an issue), because of my age and worries about egg quality diminishing over time.

WWYD?

I would go for another fresh cycle. My thinking would be, by 40 your odds of success start to drop rapidly, so you may as well retrieve as many eggs as you can as soon as you can. That frozen blastocyst isn't going anywhere; there's no particular time pressure to use it right now.

Given that you didn't respond amazingly to stims, I'd also be talking with the clinic about any suggested changes to the protocol for next time, and any recommendations for improving egg quality.

Best of luck!

@Persipan thanks, thats kind of my thinking too, it seems to make most logical sense. I think they put me on the short protocol and gave me a low dose of meds as they were worried about overstimulation because of my PCOS, but only one ovary responded - the right one literally did nothing! Are there ways to improve egg quality?

My oldest two children are both from FET after failed ivf cycles, can you do a FET while getting booked in for a full cycle?

Should have said not twins, one from cycle 5, one from cycle 7

@MissSmiley did you have a break between the fresh and frozen cycles?

I will speak to my clinic about timings, although I don't think there would be a delay in booking for another fresh cycle?

I agree with Persipan. We did two FETs after a fresh cycle and neither worked (though the fresh cycle actually did). We wanted a second child and I regretted not going straight into a second fresh cycle straight away, instead of relying on the two frozen embryos (of course, fets often do work). I was same age as you are now op.

I found the ebook 'it starts with the egg' good, though I'd definitely check with your consultant before trying any of the supplements she recommends, as not all work for everyone.

@OstrichRunning thanks for the book recommendation, will check that out. Do you mean that your second fresh cycle worked (sorry, my head is a bit all over the place today and I just couldn't work out what you meant)?

I had similar problem expect I'm 35 - I decided to do a double FET to use up the ones that were frozen after a first failed cycle and then move straight into a fresh cycle as I'm not convinced the quality is good and I've been working on changing diet and extra supplements (did get pregnant but was ectopic)

I'm doing short protocol mild ivf though so my ivf cycles are only 10 days compared to some whose are 6 weeks or longer so I can cycle a lot quicker than most

Also bear in mind that most clinics actually get better results with FET as there is evidence that it's more likely to be successful than a fresh transfer as the body has time to get back to a more natural state after all the ivf drugs

@itwasalovelydreamwhileitlasted interesting about the better results with FET - my worry is what if the blast doesn't survive the thaw? I would have been on meds for 2 weeks for nothing.

I know it came out mangled Yes, our second cycle did work. I did a high protein diet during stimms only. Not sure how scientific it is but it felt good to be doing something! Also took coq10 (a form called ubiquinol I think).

Best of luck with it.

I heard that too re better results from fet in some clinics, but your chances there will surely stay the same whether you do the FET transfer now or in a few months time. Whereas a few months could make all the difference regarding egg quality for a fresh cycle...

@AliciaWhiskers I was really worried about that too as I had to do a freeze all due to OHSS and only got 3 frozen out of 12 eggs fertilised (so your numbers are actually pretty good for the amount you had collected) and was panicked that we had spent all that money for nothing (a friend of mine didn't get any to blastocyst stage so didn't end up transferring any!)

I spoke to clinic about it and they said the odds of losing any during the thaw process is really really small

Did they grade your blastocysts before freezing? Mine wouldn't freeze anything less than a CC as those aren't likely to survive a thaw - that's why clinics grade them - for them to assess how they'll cope with thawing etc x

I heard that too re better results from fet in some clinics, but your chances there will surely stay the same whether you do the FET transfer now or in a few months time. Whereas a few months could make all the difference regarding egg quality for a fresh cycle...

Yes, that's very true.

@itwasalovelydreamwhileitlasted they did grade them I think. I asked them that when they called me on day 2, and they graded 1 a 1 and the other a 2 (obviously use different grades to your clinic) with 1 being the highest grade. I'm assuming that was the one they transferred, but I don't know that for sure. And I don't know if the grading changed before freezing (can that happen?)

@AliciaWhiskers no break just straight on to the next one, probably three months between in reality

I conceived DS on a fresh ICSI cycle. I then had a FET with the embryo left over and got BFN. I then had a new cycle and was advised to 'freeze all.'

My first cycle when I was 34 I got 15 eggs and ultimately 2 embryos. My most recent cycle at 36 I only got 6 eggs and 1 embryo. The embryo didn't survive the thaw so I had nothing to transfer and nothing left. The embryo was a top grade too and I was just told that it happens in 4% of cases.

I think it depends on your clinic's advice. I was told that there is no difference in success rate between fresh and frozen transfers. My experience would suggest otherwise but there you go. In your case I think I would go with what you're thinking. Good luck!

@MissSmiley why does there end up being a 3 month gap?

@Ginger1982 thanks for sharing your story. Were you having a medicated cycle when the embryo didn't survive the thaw? I'm sorry it didn't work out. That's probably my biggest worry about doing the frozen cycle with only 1 in the freezer

@AliciaWhiskers my clinic preferred it to allow your body to recover but it was some time ago

I’d bank some more embryos with fresh if I were you for the future. Good luck

@AliciaWhiskers yes it was medicated as my periods are irregular. It was a huge blow to be honest. Having gone through everything, be all ready to go to the clinic that morning and then get the call was pretty awful. You just don't think you'll be in that 4%

DP isn’t sure about doing the fresh cycle. He went through ivf before with his ex partner, so I can understand that, I think he’s finding the failure of this cycle more difficult to deal with than me. I’ve got 2 children from a previous relationship - this would be his first. He wants to go for the frozen cycle, but isn’t sure about another fresh. We need to process this one first...

@AliciaWhiskers Sorry to see your thread.

I can't help with whether to try for a fresh or a frozen - some of that will be down to the cost, whether you are up to having a full fresh cycle again and may be something to speak to the clinic about. You usually have to wait at least one clear cycle before you can start again.

I'm 35 (PCOS but high AMH) and DH has severe MFI.

My first cycle failed - only one ovary responded and only 1 egg was collected which didn't fertilise. I also have PCOS and was on a short protocol with a low dose of stims.

For my recent cycle, they put me on a long protocol and a higher dose (actually think it is normal for others - I just had a low dose the first time) and I ended up with 13 eggs collected. Granted only 5 fertilised and 1 made it day 5, but I'm blaming DH for that!

Other than the protocol change and the higher doses, the clinic told me to take Omega 3 (I forget but I think it was 1000mg) and Co Enzyme Q10 (100mg) as they help improve egg quality. I bought them in tesco as their vitamins were cheaper than superdrug, especially for the CoQ10.

There is more on those changes in the It Starts with the Egg book that others have recommended.

Hi @CornishMaid1. Thanks for your reply. I am trying to arrange a follow up with clinic for mid August so we can talk about things. It sounds like your first cycle was the same as mine, so that's interesting that they put you on the long protocol and the higher dose/non PCOS dose for the recent cycle. When I first went into clinic, the doctor advised me not to take any supplements, but I wonder if that is so she could start me on stuff in the future and see if it made any difference. Did you do much else to improve egg quality? I'll have a look at getting that book.

I spoke to the embryologist yesterday about the quality of the blast that was frozen and that was a 4AB (they put back a 3AA), but as someone else said on here, that egg is frozen at my current age, and the longer we wait, the older my eggs will get.

Bleeding has started today, and the weather is vile. In a total grump, and just want to be able to sit and mope, but I'm at work today and we are moving house this weekend, followed by having DP's family to stay next week and then a holiday with my children next week. It all feels a bit much today. I'll blame the hormones!

@AliciaWhiskers I have to say I looked at the book, but really didn't follow much else - I really wanted to go all clean living and no plastics and I think it lasted about a day!

I meant to try changing lifestyle between the two cycles, but the only two changes I made was the CoQ10 and the omega 3. The clinic said to go for a mediterranean style diet as well, but that didn't last too long before I forgot.

The supplements may have helped, but the change in protocol I think had the big difference for me - they did drop my dose at one point because I was responding so quickly, but they will just keep more of an eye on you.

You are entitled to be as grumpy as you like and the weather is vile.

Sorry @AliciaWhiskers you’ve had a rubbish time.

I would try and push for next frozen round but that’s only because I had an embryo thawed on Thursday for transfer and it didn’t survive. It was a 5aa too! 😫 they thawed another and it did survive and in currently 2dp5dt. Wish you lots of luck on whatever you decide to do c