Egg collection - all eggs immature

[NewSew00]

Hi all, wondering if anyone has any advice/insight on the below?

I had my egg collection today for my first IVF cycle. It was mild IVF, so was never expecting a huge number of eggs, but was told afterwards that from 7 follicles they got 6 eggs, which I was happy with. But then the Dr came in shortly after and said that ALL eggs were immature?! I had never heard of this happening before, does anyone have any experience of this or any idea why this might have happened?

The egg collection was on day 11 of my cycle, before this I only had 7 days of Bemfola, then 4 days of Cetrotide, so I'm thinking it was done too early? My last scan was Wednesday, is this normal, to have a scan so long before egg collection (Saturday)? At this last scan one follicle was 19mm, two were 16mm and there were a few more 13mm and below. They did say today that the follicles were the right size, it's just the eggs inside were immature.

They said they would do IVM to try to mature them, but I don't believe this has a huge chance of success so I'm not holding out much hope.

(In case it's relevant, I'm 34, AMH is 11.5).

Sorry that happened to you. I’m in no way medically qualified at all, but I did hear of someone else who had no mature eggs so they did a double trigger injection on their next cycle and that helped. Might be something to ask your doctor about?

@NewSew00 Hi, sorry to hear that. I'm afraid I can't give you any answers unfortunately as I too am in a similar position. In my first round I had 6 eggs and only 2 were mature and neither fertilised. I really wasn't expecting this and it hit me pretty hard as was expecting to get a bit further and now I'm worried the same may happen again.

They have adjusted my meds for my next round. I'm having a higher dose of Meriofert and they've said they might let me go 1-2 days longer before EC. I've also been taking Q10 also as a supplement but I'm not sure if that will make much of a difference, I can only but try.

Have they gave you any insight into the cause or future treatment at all?

Sorry I misread that, glad there's still a chance for you 🙏

I’m so sorry, you must be devastated. Did you have ICSI or IVF? They don’t ordinarily check their maturity unless they do ICSI. They have to strip the eggs & examine them for ICSI hence having certainty about their maturity.

I had this problem last week on my second round of ICSI with 8/9 immature eggs despite good follicle size. It’s quite rare if the follicles are the correct size (14mm and above) at collection, normally you get upwards of 75% mature eggs. I had a double trigger injection as well.

They managed to mature 3 eggs in vitro & fertilised them the next day, but they all degenerated by Day 5. The success rate is very low for IVM eggs. My only mature egg failed to fertilise.

As it was my second round we’d done all the right things - ubiquinol x 600mg, etc.

For me I have endo and they believe the resulting pelvic inflammation has prevented maturation so I’m off to see an endo specialist again. I’m really sorry to hear your outcome & I hope you get answers x

Thank you all for taking the time to reply. It only happened today so haven't had a chance to speak to the doctors yet about why they think it happened and what they might do differently next time.

@jcurve - I'm sorry you've gone through this as well. It was indeed ICSI, and I actually have endo as well (laparoscopy in Feb removed all there was at the time) so it sounds like we may have a similar issue. I too am on 600mg ubiquinol and am taking all the recommended supplements for endo in It Starts With The Egg.. Wishing you all the luck with your visit to the endo specialist, guess I will do the same soon too x

Just as as update for anyone who might search for this issue in the future and land on this thread, I've just got back from my egg collection on another cycle so thought I'd share my experience....

After my last cycle I went straight into another, first time was short protocol, this time I did long. I had 13 days of stims and they let the follicles get reasonably big, so at my last scan, the day before trigger I had five between 23 and 19mm and another six between 18 and 15. They also gave me extra LH as they said that might help with maturity and I had a double dose of Ovitrelle for trigger.

At egg collection they retrieved 6 eggs, 4 were mature and two were immature (one "very" immature, embryologist said) so I think that I just need much bigger follicles than normal to get a mature egg from, since two of my immature eggs were likely to be from 18-20mm follicles.

Hope this might be of a help to someone else x

Thanks so much @NewSew00 for sharing your experience! I just went through my first round of IVF and got 24 eggs but all were immature which I was devastated about, the doctor advised it was either the protocol or problem with my eggs and they won’t know until they try another protocol but this gives me hope as based on my research it isn’t very common to get all immature eggs but fingers crossed for round 2 and a change in protocol! Thanks again!

Hi @Gg120 - I'm so sorry you went through that. Do you have PCOS? 24 eggs is a lot, I think it's a bit more common with the more eggs you have, but that's good - it means you've got a better chance next time if they want to reduce the meds a bit to get slightly fewer eggs which should allow your body to have more energy to maturing the ones you have then.

Definitely push for the double trigger as well - my first clinic didn't want to do this, luckily my second did and they say that was likely a big part of getting the mature eggs the second time.

Good luck and I have my fingers crossed for you! X

@jcurve and @Dbrook - have you had further cycles since the above messages? Any progress with the egg maturity issues? I've obviously got an ongoing problem, had another cycle and only one mature egg despite big follicles and double triggers. Really don't know what to do now.

@NewSew00 I’m in a similar boat. My last cycle I had a double trigger but only 5/20 eggs mature. Based on previous cycles, I’m 99% sure it’s because the hcg trigger wasn’t high enough. It was only 2500 of pregnyl. As soon as they told me the amount I pushed back but they said I was too high risk for ohss. Wish I pushed back more now. Any update since you posted?

@NewSew00 That must have been really tough for you, particularly to be told that when you've just had the EC.

A lot of my eggs didn't mature properly in my IVF round. I have a change of protocol for next round, including delayed egg retrieval (leaving a longer time between trigger and egg retrieval) to try to help make sure they've had time to mature before collection.

Best of luck

Hello everyone, following this thread recommend by @newsew00 as I am also in the same situation.

Has any of you had some sort of luck in new cycles? If so, what changed in your protocol?

I have just finished my 2nd round of IVF and I also had 12 eggs collected, none matured. First cycle was 10 eggs and all of them immature. My trigger was buserelin with 1ml first time, 2ml second time.

I haven't spoken to the consultant just yet but just wondering if have any recommendations about what I should ask them in the call?

I have never heard of buserlin used as trigger. Gonasi is what I have used on my cycles. I think you should ask about another trigger shot.

@Francesmalin @Bonster37 I had a Buserelin trigger my second time round (which actually gave me an ok number of mature eggs). Its used with antagonist protocols and those liable to develop OHSS. You can do it as a dual trigger with hcg, but clinics don't like that if you're at risk for OHSS

Hi, I have been in this boat. Used to have good number of eggs collected but none matured. Afterwards, 1-2 used to mature in lab, that we would transfer. But either BFN or CP

Trigger i have used for all cycles is Ovitrelle.

In my 4th cycle (that was successful & I am 14 weeks currently) I had 12 eggs collected. One was mature; 5 matured in lab later; 3 fertilized; 2 survived until day 5. Transferred 1; one is freezer
The difference was my clinic changed my protocol from short protocol to long protocol. But it wasn't standard long protocol. I had 1 shot of Zoladex (down regulation). I bled after 19 days. After periods finished, I started stimulation around day 7 or 8 of the cycle. I took pergoveris which is a mix of FSH & LH

So it appears that the long protocol might have helped.

@morningvenus that is a good news! I am glad to hear that it worked! It gives me hope. Can I ask which clinic are you with? The reason why I am asking is because I am with Create and just yesterday i had my post treatment consultation and the doctor told me that after 2 failed cycle he doesn't think I will be successful with IVF in the future. He suggested to do Natural IVF or Modified Natural IVM. I don't really trust they have experience with similar cases so I am looking for new clinics/specialist that have experience with cases like our.

Any recommendations will be very welcomed!!! x

Hey @NewSew00 I had IVF/ICSI recently and got 17 eggs, virtually all of which were immature despite my follicles all being perfectly sized. It sucks and the doctor said there is no way they can even ever know why, so the answer next time would be to try a different trigger. If you hear anything more helpful let me know!! Good luck xx

Gennet in Prague for last two cycles

Got some updates. Not sure it might be helpful for everyone here but might be worth looking into few thing for those of us that have immature eggs. I spoke with a fertility coach and we have been through my case etc and it seems like there could be 2 "issues" with my case:

1. PCO: I have PCO and because of the number of high follicles immature eggs can be a thing over the course of normal cycles. Now this doesn't mean I am not able to produce mature eggs but they might take a bit longer. To support the maturation of my eggs naturally I need to change my diet and add more proteins, antioxidant and supplements to improve ovulation and overall wellbeing. I also need to reduce stress quite a lot cause over the course of the last 9 months there has been periods when my prolactin has been on the high range and this value influences the levels of FHS and LH that go down.

1. Protocol with my clinic: Looking at the blood tests during both my IVF cycles, the oestrogen rises very quickly. When this happens FHS get suppressed cause the body thinks follicles are big enough or have already ovulated. It seems like that rather than oocyte maturation failure the problem is with the drugs not stimulating me properly.

I still need to have a proper second opinion but I feel in a much better place now. Might be a new clinic that is not a franchise can offer me the right customised treatment and look into my case in the best way possible.

@Vparisi what did the clinic tell you about your case?

Have a good week end!

Hello! How's everyone doing?

I have had a second opinion about my case and the consultant said that my issue might be I don't respond to buserelin. My consultant has experience with cases similar to mine and he mentioned that a small number of women don't respond to that trigger. So next cycle I should have either ovitrelle (or similar) or mixed trigger and also have my eggs stimulated for longer period of time. Let's see what happens with the next cycle!

Hi @Francesmalin how did you get on in the end?
Just wondered as I have just had a failed ICSI round and out of my 13 eggs we only had 3 mature.

@lemons44 i never matured eggs after 4 cycles so I'll no longer pursue IVF. Unfortunately Egg donation or adoption adoption or childless are my alternatives.

What has your clinic said? Ask for a follow up consultation and maybe look for a second opinion to try again with a different protocol. something that usually works is double trigger that helps with eggs maturation.dr Dimitri psroudakis is great IVF specialist with experience in egg maturation issues if are in London and want to get a second opinion with him

Hello, just an update for anyone searching for this topic in the future (when searching for things I always found it useful to find out what happened with the OP on the end.)

So as a summary, whilst I thought we'd cracked it after my second cycle with mature eggs, it turned out they weren't mature in the end. I ended up having 5 cycles overall, different drugs and protocols each time but in all those cycles only every made 3 mature eggs. There is simply something wrong with my eggs that mean they don't mature properly. From my extensive (!) research on this or appears that if this happens to you once (having a cycle with all/most eggs immature, then by changing protocols etc you have a good chance of your second cycle being different and being successful. However if the second cycle is equally unsuccessful then your chances of it ever working are very low (as likely you'll have an inherent egg problem)

Last week I gave birth to a beautiful baby boy via egg donation. Looking back over my journey, whilst it was devastating at the time, now I wouldn't change a thing otherwise I wouldn't have him. Sending love and hope to anyone going through something similar x

Hey @NewSew00 thanks for the update. Same here. After 4 cycles of IVF with my own eggs and different protocols and all my eggs were immature and really weirdly shaped we have decided to move on with egg donation. It took me a long year and more to accept it but we have now identified a clinic and we'll move forward.

Hi @NewSew00 a huge congrats to you and thank you for coming back to update. So in the end did you get any mature eggs? Hope you are enjoying your gorgeous newborn 💗 so happy that you have got your happy ending.

Hi @Francesmalin apologies I didn't see your last message. Thanks for coming back to update too. Did you get any mature eggs in the end or were all immature? I'm happy that you've made peace with egg donor and it must feel exciting for you to be progressing with next steps.

We are preparing for round 2 now and I'm already worrying we may have a similar issue, although hoping that with changes we may get a better result. My husband needed a surgical sperm retrieval as he has obstructive azoospermia so we only have 3 vials of his sperm left and it's an additional stress using a vial each time if not getting many mature eggs. This journey is so stressful.