Worsening results

[Shamoo]

Hi all - hoping for some inspiration and also any learnings that people may have. Same sex couple so never tried naturally for a baby.

I had my first round of IVF in March 2019 when I was 38 - 16 eggs collected, 15 fertilised, 7 day 5 embryos all good gradings (ranging from 5AA to 3BB). Didnt know how lucky we were at the time! Fresh embryo didn't take, but then I had a number of miscarriages (2 x MMC, 2 x chemical). We have one left in the freezer from this round.

We did another round in June this year (so just before I turned 40) with the same donor. 14 eggs collected, 12 mature, 8 fertilised, 3 at day 5. Fresh transfer of a 5AA didn't take again. Other two still in freezer. We had been going to genetically test the other two but due to numbers decided not to. But then the 5AA didn't take I got even more worried.

Since then done two more rounds with a new donor (thought it was worth trying a different option) so we can genetically test to try and get some more info. First of these rounds in September I was over stimulated, 29 eggs, 14 fertilized, big drop off between day 1 and day 3, and ended up with two. Both genetically tested, One good now in the freezer (a 3BC) and one (the 4BB) bad and not able to be used. But at least I now have proof I can make generically good ones. Just finished another round where got 16 eggs, 11 fertilized, 9 at day 3 and just one at day 5 (a 3BC) which is also being genetically tested (I have low hopes but fingers crossed).

So overall my results are getting worse everytime I do a cycle, and whilst I am getting older (and therefore can understand the difference from when I was 38 to now I am 40) the ongoing drop off and worsening results has me really worried, especially the change over the last 5 months. Like have I ruined my body? Should I give up? Do I need to change something? Is the genetic testing process harming them at day 3?

Does anybody have any experience with something like this? Any words of wisdom?

Thanks so much in advance!

I should add, for context, that my partner is happy to carry - which is why we are trying to build up a number of embryos before I get too much older.

I did 5 egg collections in little over a year and found it was harder and harder to get my body to respond - I was age 36-37 at the time. The final 3 cycles were natural modified IVF too so much less drugs but it was clear my body had had enough by the 5th one.

When you think about it you have forced your body to produce 75 eggs in 18 months - basically 6 years worth of eggs had you ovulated one a month naturally. Most egg development starts about a year or so before ovulation when they start to move through the various stages of maturation and so I would say you results are worsening because you are forcing your body to mature follicles/eggs it would never have chosen itself - hugely bypassing any kind of natural selection. Obviously this is a controversial topic for clinics who aren't going to want to admit this when they have a client willing to pay to do cycle after cycle

Also OHSS /over stimulation Is also known to reduce egg quality significantly- I've known women get 30-40 eggs and have a huge drop off day 1-3 and nothing to transfer.

They shouldn't really be PGS testing them at day 3 - HFEA shows virtually no improvement to success rates when done at that stage - they are normally done at day 5? PGS testing shouldn't harm them but it isn't 100% accurate.

I had multiple miscarriages and ectopic- a really bad PGS round where didn't get any normals and decided to stop testing and rubbish fertilisation rates with ICSI with short protocol IVF. I changed to natural modified IVF focussing on 2-7 follicles instead of 14+ and fertilisation jumped to 100% from less than 30% and I'm pregnant with twins.

Quantity isn't everything - for me fewer follicles meant much much better quality so maybe it wouldn't hurt for you to try a low dose drug cycle?

@ivfbeenbusy I just wanted to say thank you for your reply and sorry it has taken me so long to respond, I have been reflecting on it all and getting to grips with it. I really appreciate your response and wish you all the best with your twins. 🙏