IVF Poor egg quality?

[IOTO]

Hi,

First cycle of IVF. Throughout my scans I responded well to medication and had 12 follicles. Day of egg retrieval only 5 contained an egg. 2 fertilised, 2 made it to day 3 but didn't change by day 5. We did IMSI. Dr says to increase meds and use Menopur as this may increase the number of eggs.

When last tested my AMH is 28.1.

Due to low egg retrieval, and that neither made it to day 5, I'm worried my egg quality is poor. Have been told supplements can be taken but do they really work? Can you improve egg quality?

I just don't want this to be the end already 😕 x

Hi @IOTO how old are you and what is you AFC? that sounds like a good AMH and 12 eggs is a good outcome.

I thought after day 3 it's more to do with sperm quality than egg quality. I take it you guys have MFI if you were doing IMSI? Others will know more about sperm issues than I do, have they explored this sperm issues eg DNA fragmentation.

Thanks for your reply. I'm 33. DH's fragmentation results are not terrible but out of the normal range.

We had 12 follicles but only 5 eggs within those follicles, which is much lower than our dr expected. I'm going to get my AMH retested before starting cycle two.

What is AFC? X

I wouldn't have thought there's any need to repeat the AMH. The AFC is more important, it's the antral follicle count. They count the number of follicles in each ovary, each follicle has the potential to react to stims and have an egg in it.

It's a bit strange that half the follicles that were growing were empty, sounds like they need to adjust your stims protocol.

Thank you. I'll mention the AFC and see if I can have that test. Will update with how things are going should anyone else find it helpful. X

They would already know the AFC, I was just wondering what it was because that gauges how many of your follicles responded. Eg did you have exact 12 follicles and they were all stimulated too much leading to few high quality eggs, or is your AFC very high and they just didn't get things right.

I have a very high AFC of 34 so they put me on a low dose short protocol, they didn't want all my follicles growing as that would have put me at risk of OHSS. In the end I had 12 eggs harvested.

I think you need to get a consultation booked in and find out what they recommend in order to achieve a better result from your stims. I hope you can have a productive meeting with them

@IOTO my IVF consultant suggested vitamin D supplements and my next round had far better results in terms of the number of embryos that got to good quality blast stage for freezing. Might be worth a try if you’re not already on them. Good luck!

@IOTO it could also be that they didn't stimulate you enough, majority of the times it's the fault with the protocol when you fail to get mature eggs !

I am in the same situation as @Gardenlady543 I have pcos and my estrogen levels climbed on day 9 so nhs IVF consultant asked me to stop all the drugs and take the trigger inspite of just having 2 out 20 eggs the right size. This obv means I won't be getting any eggs and it's a doomed cycle for me

I think there were 12 main follicles with a few smaller ones that weren't big enough. Apparently it could be that the eggs are stuck to the follicle wall so consultant will do something (not sure what) to see if that's the case. Hopefully I'll respond better to more medication - I'll be going onto Menopur next time.

Consultant suggested ubiquinol or CoQ10 so I'm going to start taking that. I have been taking vit d but not consistently so will keep that up.

Thank you for all your replies - you've made me feel better. I'll keep you updated :)

@Rj1988 sorry to hear that. Hopefully they can make changes next cycle.

Hey, just wanted to say I'm in a similar situation. I'm 32 and have an AMH score of 21.5 and 'unexplained fertility'.
My first cycle I did everything possible health wise and supplement wise. I had 15 follicles, but just 8 eggs retrieved with only 1 of then making it to day 3 which they transferred but it didn't stick. They suggested poor egg quality.
This cycle I had 4 follicles despite changes to meds. The clinic gave me the option to abandon the cycle due to my poor response but e decided to just go with it and somehow they retrieved 6 eggs on the day, of which 5 have made it to day 3 and have been graded as good or outstanding. Booked in for transfer on Saturday. It seems so strange and unbelievable but I think every cycle must be so different and you might think one thing and then it changes the next time around? I'm not sure what my point is really but I just want to say not to give up hope yet and wish you all the best!

@Tara8 - wow that's great! Do you know you did differently the second time? They say it takes 90 days to improve the egg quality.

Also was your protocol different the second time? Would be great if you can share how long they stimulated you

@tara8 thank you for sharing. I really hope your transfer goes well - keep us posted.

I must admit the only supplement I took ahead of cycle 1 was folic acid (for a year and a half), and didn't realise the importance of other vitamins and things like ubiquinol. I also ate chocolate and drunk tea so I've now cut those out.

Thank you both. We had quite a gap between cycles, 7 months, in which time I haven't really done anything apart from take a Tesco multivitamin for the last 2 months. I think after 4 years of trying to conceive and then a failed cycle I had become a bit despondent by the second time around as felt like all my efforts had amounted to not a lot.

For the first 4 years and the first IVF cycle I was really strict with myself and had no tea, coffee, caffeine or alcohol (much), I ate really well, exercised every day, took Pregnacare supplements, CoQ10 supplement, drank lots of water...and I'm sure there's more!

First round I was on Menopur 112.5IU for 9 days before I took the trigger injection, with Fyremadel on the last 4 of those 9 days as well.

= 15 follicles, 8 eggs retrieved, 5 fertilised, 1 left on day 3 and a BFN

This time I was put on Menopur 75IU and Ovaleap 50IU for 11 days before the trigger injection, with Fyremadel on the last 6 of the 11 days as well.
= 4 follicles, 6 eggs retrieved, 5 fertilised, 5 left on day 3 and hopefully at least 1 for transfer tomorrow (day 5)

For me, so far anyway, it seems like quality over quantity.

@Tara8 - thank you for sharing the details and I wish you all the very best for your transfer tomorrow.

I have been trying for 2 years as well and not sure when I will see the end of it...
its interesting to see how food habits have very little control on the actual outcome

Hi @Tara8 - how did your transfer go?

What kind of trigger shot did you have? If you do another round you may want to ask for a double trigger. Xx

I had the double trigger as my blood test was 6,000 which was low for the amount of follicles I had. I'm skipping this month so I have a break in between cycles.

Hi Tara,

How did it go?
I am 33 and this was my second attempt.
Collected 20 eggs and all were arrested apart from 1 which they froze.
Nurse said that she thinks I have poor egg quality.
Would like to you know how did your transfer go and did they grade your embryo?

Hi @Rj1988 I sent you a message, did you get it?
Just one decent egg left by day 5, graded a 2AA. All the others weren't of good enough quality to survive the freeze so just had the one transferred. Not holding out any hope!
When will you have your transfer? Did they grade before freezing?

I had a bad fertilisation round once and getting a double trigger for the next did help. I recently saw on a different forum that someone had a triple trigger. I always had menopur and apart from that round I always had quite good number of embryos for someone with a low AMH. There are lots of women that feel that they have made improvements with supplements. I have been terrified my eggs were bad quality but I found that you cannot tell from one round. You can just be unlucky and have more success the next. Xxx

@Tara8 - wish you all the best and fingers crossed xx

From 20 i only got one blastocyst which was graded 5AB

I am reading a lot of articles where they say Expansion is the least important out of three and AA is the best grade so there is hope for you!

Nurses told me i have very poor egg quality and all of them were slow growers.

I wonder if people can suggest how to improve egg quality

Thanks @Rj1988 it seems we have similar issues with eggs not surviving but I'm not sure why this is? Is it a natural/genetic thing or something you can improve on?

Do you know when your transfer will be?

I'm getting all the usual pre menstrual symptoms so I'm just waiting to take the test and then I can stop the progesterone and it will all be over! I was pregnant once before, about 3 years ago but it ended in miscarriage, so I kind of feel like I'd know if I was pregnant again now.

So today was the test day that the clinic gave me and I have a faint but clear line. I would have though the line would be a lot stronger by now though as I am 14 days past retrieval and 9 days past transfer. Just a bit worried it could be a chemical maybe as I don't feel anything? The tests they gave me are just though cheapy strip tests...

@IOTO I'm in a similar situation. I'm 32, AMH 18.8. First IVF round I was on menapur for only 6 days when clinic asked me to trigger (for reasons I still don't understand why). They expected 7 eggs, got 4 of which only 2 were mature. I was told my eggs wouldn't come away from follicule wall as were still immature.

I was lucky in the 2 mature eggs they got made a 5AA and 4AA day 5 blast. Fresh transfer was BFN and my FET transfer has just ended in a chemical pregnancy.

We're doing one last egg collection round. Subject to repeat AMH bloods I'm being moved to a Flare protocol which I hope will make a difference.

I still feel very unhappy about when they triggered me - I feel my eggs needed a lot longer to mature, and I had so many smaller follicules developing that we could have afford the elad follicule being over-mature to have more eggs in total. Still feel cheated out of that cycle (and we're not elligible for NHS funding as a same sex couple until we have paid for a lot of attempts ourselves so this is costing us a fortune)

@2mumlife It's difficult, but now you are aware of where things need to be maybe you can speak to the Dr if they want to trigger too early again? I was on bemfola for 11 days so I'd have thought Menopur will be similar - 6 days does feel short.

The cost is crazy for private treatment. We've skipped a cycle to take a breath and hopefully improve egg quality.