Too high doses of IVF medication- poor egg quality?

[Nats19]

Hello All,
Wondering if anyone here has any experience of positive ivf results after lowering the stimulation protocol?
I had 2 rounds of ivf in which I produced 48 eggs total, 7 blastocysts, none of them normal after PGS.
Changed clinics- new one is very thorough. Turns out my AMH levels from last year were wrong (apparently there have been issues with this test) and when I retested last week, the level more than doubled (from 12.7 to 33.5, I am 35). This means I was very overdosed on my previous cycles and am wondering if that had an effect on egg quality...
Any insights most welcome!

Does sound like you had OHSS in your first two cycles - every post I've seen where there were loads of eggs produced actually only ended up with same number of mature/fertilised ones as those on lower dose/didn't have OHSS so that does suggest that it affects egg quality

What dose were you on previously and what are you on now?

As a comparison my AMH at 35 was 12.9 I was on 225ml Bemfola and for 14 eggs (but also did have early stage OHSS and only got 3 to blast and egg quality was noted as poor!)

I wondered about OHSS but I didn’t have symptoms- I felt quite ok.

I was on 300 bemfola and 75 mémo pur and now it will be just 150 pergoveris to begin with and be adjusted as needed.
For sure those doses were to high for an AMH of 33.5

I meant 75 menopur

www.huffingtonpost.co.uk/dr-geeta-nargund/ivf-negative-effects_b_8401238.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAANJTqyUwUo4tauD6VUV6xRU4HJzAByHRDrQv4hPzII19GQjfV-7f2eXy2QRo0S57J62MllIDUkInzIsN073WvBU3Y3ABsTQIyHs8hLCUgL8V8EpO4haEiear5oZT_0y5VzQD8NaKGUjz_9HNvpSb7zFHVsK3za1HPtBD1-G5LNYg

Research says it does. I had 450 menopur at my first cycle with an AMH of 1. Now at a different clinic 6 months later and they are completely against that high dose again, even thought my FSH and LH are below normal levels.

though*

I had 450 menopur and got 20 mature eggs (despite low amh and high fsh). 14 fertilised but by day 5 we had no good quality blasts.

Second cycle I had 300 menopur but got 22 mature eggs - 13 fertilised (this tome with surgically removed sperm). By day 3 same thing seemed to be happening and we only had 4 blasts “still in the game” transferred 2 (one now my son) and the other 2 made it to blasts.

Just went to chat to consultant about trying for number 2 - he said if we needed a fresh cycle (I.eFET don’t work) then he’s lower the dose further to try and improve egg quality and get more blasts.

Not sure if that answers your question or helps - but consultant certainly thought lower dose would make better blasts!

I'm not sure really through as I think I was a bit of an anomaly and I don't know in relation to you if my medication was high but when I was in a lower dose I failed miserably. I was only on Gonal F and was on 150. I only got 4 eggs and 1 got to day 5. My dose was upped to 250 which was high for me and I actually got 27 eggs. I don't know however if the key to quality here is not getting OHSS? I didn't at all and 15 eggs made it to day 5. So persons the quality is linked to OHSS and not the number. My trigger was Buserelin, not a HCG trigger. What sort of trigger are you having as that could be affecting whether it's OHSS.

Are you taking supplements? High protein diet, etc? I have only done one cycle so no expert but did supplement with fish oil and 200 of ubiquinol daily, plus the usual pregnacare etc. I also switched up my usual toast only for toast plus eggs, and also the odd protein shake as a snack. And acupuncture for good measure. I got 4 5day blasts out of 8 eggs collected and am 36, which I felt was quite good given I hadn't been looking after myself that well prior. That was on 450 of gonal f, which is high, but I triggered a couple of days early for other reasons. If nothing else I also have weirdly strong nails now after a lifetime of splitting, breaking nails, which makes me think the supplements do do something!

Thank you all for your messages!

@Ginandtonic31 I think they upped your dose because you had a low response, which makes sense. Before my first cycle, the consultant estimated i would get 10 eggs, but I got 20. And the result was poor egg quality- I am a bit surprised they didn't want to lower doses then...

@peachesforfree- I am on 200mg COQ10, Inofolic (they think i have a tiny bit of PCOS), my husband and i take Impryl, and I take royal jelly on top. And I am taking something to lower thyroid levels. My nails are also amazing- yay silver lining! I started all of this after my second round, so I hope it will make a difference. Is there any update on your cycle, was it successful?

@hoping2018- thank you for sharing that- it reassures me to hear that. I hope the FET works for you tough!

Oh sorry @Ginandtonic31 I was triggered with dual burserelin and HCG

Ivf no1 for me resulted in 11 eggs, 9 mature, 7 fertilised and they were all crappy by day 3. This was nhs place standard same dose of injection each day for 12 days. It was a high dose I had low Amh but normal fsh.
Ivf 2 resulted in 11 eggs, 9 mature, 7 fertilised. 7 blasts. 5 in freezer. Totally different set of results I was literally amazed. I had less than half the medication I had on Ivf 1. I’m sure it was all the meds that made me get crappy eggs = crappy embryos.

My experience is why I feel so keenly for people that they need to try different doctors. I honestly thought after Ivf 1 that my eggs were doomed and this would never happen for me. Best decision my husband ever made - talking me into going to the expensive but thorough clinic when I was scared to spend all that money.

Thank you @Waterdropsdown that is just so good to hear! Our initial clinic said the more eggs the better, whereas a few other experts have told me that’s not true- who to believe? I am going to trust our current clinic and hope for the best!

@Nats19 yes they did uk it because of bad response. But I just wanted to show that I don't necessarily believe lots of eggs result in poor quality every time.

@nats19 my belief is probably that more medication can likely cause lower quality as opposed to actual number of eggs because I made the same number with 50% of the meds. But they were amazing quality (and 2 of them are real life children now).
Anyway good luck. I just know when I was in your situation I liked to hear of similar stories that worked out.

A lot of things can impact blastocyst quality from thyroid function to the presence of certain genes or even an insufficiency of omega 3. Drugs shouldn’t have impacted blastocyst quality to the level it did for you - I’m guessing something else is wrong

@Teddybear45 our first clinic seemed to agree, their reaction was that we “have something that medicine currently cannot explain...”. But I do think refusing to change the protocol to see if it made a difference wasn’t a great answer...

@Waterdropsdown I understand, and really hope we might have a similar situation. I would be happy with fewer though, if they led to a healthy embryo...

Have you paid for Level 1/ Level 2 testing? That can sometimes explain unexplained infertility but clinics don’t often offer it until you have failed 3 cycles.

@Teddybear45 I did both- mostly all ok, some things like thyroid levels and MTHFR which we are handling. Slightly elevated Killer cells but that’s controversial

Thyroid antibodies can trigger an abnormal NK killer cell response according to my consultant. Mine was really high (about five times higher than any killer cell count he had seen) - corresponding with my antibody result. So I had lipid protocol alongside steroids and the other stuff.

Which clinic is this? Thanks