Good fertilisation, poor blastulation- any hope?

[KatRee]

I'm currently 6dp5dt on first ivf cycle. I'm 37 with an AMH of 11.5 and before beginning the cycle we were advised that they were expecting 7-8 eggs from me. In the event, they managed to collect 12 mature eggs of which 10 fertilised, which both we and the clinic were delighted with. However, after that good start, we ended up with just 1 blast on day 5, graded 4BB, which was transferred fresh. A second embryo made grade 4BC blast the following day and has been frozen. I understand that usually 30-50% day 3 embryos make it to blastocysts, but in my case it was only 20% and I was lucky to get that after having been warned on day 3 that it was possible none would make it (at that point I had 4 grade B, 4 grade C and 2 grade D.
I'm worried that this doesn't bode well either for this cycle or future cycles. I've come across lots of stories of people having success after having a very small number of fertilised eggs, but nothing about success after such a big drop off once the eggs have successfully fertilised. I wondered if anyone had any experience of this that you could share?

Hi @KatRee and @Phrenologistsfinger

Just checking in to see how you both are. How was your cycle, @KatRee?

Thanks for checking in @Mouseorchestra7

I'm in the middle of the '5 day wait' after EC.
This cycle has not been the best in terms of numbers, but had a day 3 update today - we have 6 embryos hanging on - 2 are average/poor quality and unlikely to make it, but four are grade A. I've never had ANY grade As by day 3 before, so I feel like this is some kind of progress. But I know there is usually a big drop off at this point, so very nervously awaiting day 5 and hoping there will be something good for us to transfer 🤞

How are you doing?

@KatRee That is really positive. I’ve only ever had one or two grade As at Day 3, so that is really good! In my last cycle, I had one A Grade and the rest average/ poor, and one of the average/poors clearly made it in the end, as I had an early blast transferred and then a 5CC day 6 frozen. I was disappointed with that outcome, but it shows that you are in a great position if you have four grade As and one of your poor/averages might also make it (as it did with me). Crossing my fingers for you! Please do update. I would be optimistic in your position, although I understand the desire not to get to swept up in optimism, etc.

@KatRee I am doing ok, thank you. Had a bit of a panic about Vit D, as had my levels tested last week and they not optimal, so going to take 12,000IU for two weeks to hopefully increase them. Have been taking 4,000 IU since Jan.

I then started panicking about various things (for example, some previously identified fibroids, the fact I’m not a good sleeper (have ordered melatonin, as read poor sleep can impact egg quality - arggh!). Just feel that I should have done more to prep myself for this upcoming IVF cycle, given I have had six months, and now worried that I have messed it up Before I have even started.

I have a call with consultant next week, so hopefully that will answer some of my questions.

Just wish that I could relax a bit. Feel that I am in this IVF tunnel of dread and I won’t escape it until I have a baby.

Good luck! And let me know how it goes with you.

That really surprises me about the vitamin D @Mouseorchestra7 - I would have thought with taking that much already you would have been well above the deficient zone. It's good you got levels tested though, I really need to do the same

How long have you got until you start your next cycle now? I didn't really start prepping for mine anywhere near like 'properly' until about 6 weeks before. And by that I mean introducing more supplements and trying to stick to a high protein/low carb diet. It feels like I was doing it for ages, but I know i was drinking and eating lots of sweet things over Xmas and new year, so it actually can't have been anywhere near the 3 months they say. I will see how we get on in terms of blastocysts before I draw any conclusions about whether it's had any effect, but I don't think you should worry about not having spent the last 6 months prepping

I've also slept really badly the last few weeks due to stress. It's so hard to relax - I think we just have to remember everyone going through ivf is stressed and yet, it somehow works sometimes, so it can't do that much harm. Hope you can find some moments of peace though x

Thinking of you too @Phrenologistsfinger , hope you're ok

I started this thread 6 months ago hoping someone could tell me that having a poor blastocyst rate didn't mean I was completely doomed to failure

Today, I'm still a long long way from a baby, or even a second line on a test, but my recent cycle has given me reason to feel very cautiously, a little bit more optimistic and I hope it gives others in this situation a bit of hope too, as it shows that results between cycles really can improve

This is my third cycle. I got the worst results in the second, and at the moment im considering that one a bit of a blip. I probably should have cancelled it at the baseline scan as the ovaries were not 'quiet' as they should be. So ignoring that one and comparing cycles 1 and 3, the results are:

Cycle 1: AFC -,12,
Cycle 3: AFC - 15/16

Cycle 1: 13 eggs collected ( ,12 mature)
Cycle 3: 9 eggs collected (8 mature)

Cycle 1: 10 eggs fertilised
Cycle 3: 7 eggs fertilised

Cycle 1, day 3: 4 x grade B, 4 x grade C, 2 x grade D
Cycle 3, day 3: 4 x grade A, 1 x grade C, 1 x grade D. (1 arrested on day 1)

Cycle 1, day 5 - 1 x grade 4 BB embryo transferred (BFN). 1 x grade 4BC frozen on day 6
Cycle 3, day 5 - 1 x grade 4BA embryo transferred. 2 x 4AB + 1 x 3BC frozen
1 x 2CC under observation until tomorrow, probably won't be good enough to freeze.

Still very nervous about what will happen next- do not watch to count my embryos before they're hatched and implanted! But, the results this cycle are so much better

Will never know why this is, but things I've changed were eating high protein/low carb diet (at least 60g protein/ less than 100g carbs/day) wasn't super strict with counting the carbs, just limited carb-heavy meals to one per day

Also started taking 300mg TruNiagen and 20mg PQQ each day on top of the 'advanced plan from ITWTE', which I was also doing before cycle 1 (except for melatonin- starting taking 3mg in the evening when I started sims in cycle 3, but I forgot to take it at least a couple of times)
Have also not tried DHEA yet
I've been taking 2000mg fish oil capsules (DHA -EPA) since cycle 1 too

Got my fingers crossed for success for everyone else here 🤞🤞

Hi @KatRee That is an excellent result. You must be so pleased. I am happy for you, and you have also given me optimism for my upcoming cycle. Clearly, things can change and be improved!

May I ask how long there was between your first and second cycle? And was it just the TruNiagen and PQQ you added? I will be ordering those!

I have my fingers crossed for you for the next stage!

Thank you @Mouseorchestra7

There was about 2 months between end of cycle 1 and start of cycle 2, and about 3 months between ending cycle 2 and starting cycle 3. I think the extra month's break helped a bit

I've had a look at the email receipt for my supplements order, as I couldn't remember when I started them exactly- and it's from mid- December, so about 2 months before I started cycle 3. It also reminded me I started taking Now Açai Berry supplements (3x500mg/day) at the same time. I also bought the melatonin then, but didn't take any til I started stims

Feeling nervous now as I never had a 2ww where I felt like I was actually in with a chance!

Thanks, @KatRee, belatedly for your last message! If my next cycle isn’t any better, I will start taking all these supplements.

How is everyone on this thread? Am starting my new cycle in about two weeks. So so nervous.

Hi ladies,

I spoke to my consultant about HGH during stims. She told me that studies have shown that it increases the number of follicles especially for people with DOR, but unfortunately the percentage of live births is unchanged. So basically it doesn't do much, but it is still being investigated.
I went to see a immunologist and I did all the immunologic blood tests (nk, kir profiles etc). Everything is ok so there is still no explanation for my failures (naturally ttc and transfers).
I am going through a shitty time. I have one embryo left and I have been trying to transfer it since last November. Almost all my transfers were cancelled due to various reasons. Meanwhile I had to start taking AD as I have some issues with anxiety/depression. Although they were supposed to be safe (sertraline), they messed my cycle and hormones very badly. Last cycle got cancelled due to low progesterone after ovulation ( I should be doing a natural cycle) so I stopped AD treatment right away. This cycle my 8 day scan showed 4 growing follicles (I am not taking any kind of stimulation medication) on my left ovary. This means that FSH was too high and it recruited too many follicles. The end result will be a anovulatory cycle or a weak ovulation so no transfer again. I have never had any issues with ovulation and according to my doctor I am not reaching perimenopause yet. The only culprit would be the AD treatment. I am so angry at myself for taking the medication. I had been reluctant since the beginning and should have followed my instinct.
I hope you guys have better news.
🍀

Hi there

@Mouseorchestra7 I've got everything crossed for you for your upcoming cycle

I'm sorry you're having a shitty time @Yuliaaa . That's such bad luck with the sertraline- I've been on that before and I was one of the lucky ones who didn't have any side effects. You must be so frustrated that things have been delayed again, but please don't blame yourself for giving it a try- it does help lots of people and trying it was the only way to find out if it might help you. I hope you are getting support and can find another means to help manage all the overwhelming feelings brought on by this rubbish situation
I can understand you being disappointed the immunology didn't show anything as I think we are all looking for a reason so we can try to fix it, but I hope somehow it has provided some kind of reassurance that your embryo will be put back into a good environment where it has the best chance to thrive.
I'm rooting for you xx

@KatRee
Thank you so much for your kind words.
I saw the doctor today (day 13). Ultrasound showed one leading follicle measuring 21 and 3 smaller ones and the lining was 8.1, but the hormones aren't right: LH 7.8, E2 250 and Progesterone 0.23. Something isn't right, the values are too low for the follicle size. I will repeat them again on Friday.
The funny thing is that when the hormones were ok lining was too thin, and now the hormones are low and the lining is the right size. I honestly feel like I am being pranked!
It is such a frustrating journey, isn't it?

@KatRee I was even afraid to ask about your transfer but then I read your comment on the other thread, so congratulations on your result! 🤗🥰

@Yuliaaa Thanks for your well wishes. I'm afraid to say it myself as it seems impossible. I'm sorry to report the anxiety doesn't really get any better! Whatever happens though, I'm trying to think that getting this far is a step forward. It shows that things can improve and I hope it helps others here know that even after cycles where everything went wrong, things can go better sometimes

The whole process really is frustrating- so many variables and factors at play. I don't know much about FETs as I've not done one - I understand they can be natural or medicated, which are you trying? I hope things have progressed by tomorrow 🤞

@KatRee I totally get what you mean about the anxiety. I would feel same.
Unfortunately FET got cancelled. Progesterone and estrogen level are not optimal.
We have been trying to do a natural FET because I am ovulating and I've never had issues with hormones before. The last two month things have changed though. I've just made a list of all the things that I am currently taking and I've realized that I've been taking l-arginine at the wrong time in hope of it increasing my lining. According to Rebecca's book it should be taken before transfer but not before retrieval/ovulation because it decreases egg quality. Suddenly I remembered my consultant saying that my low hormones might mean low quality follicles which now feels more than coincidence. I can't help looking for some answers. I am going to see her tomorrow and ask her about the arginine thingy.
Hugs!

I'm so sorry it got cancelled @Yuliaaa - that must be really frustrating. Hope you get some answers and today- I'm sure they will be able to suggest changes to have more success next time x

@KatRee yes, actually I did get some answers. The only solution is a medicated FET. Based on hormone levels and ultrasounds my consultant thinks that my pituitary gland is not functioning well and is sending mix signals, although my cycles have always been regular. This is impacting my lining which grows and then shrinks after ovulation and that is one of the reasons I couldn't fall pregnant naturally.
I need to do some blood tests/smears etc and a breast ultrasound and if everything goes well, I should be doing the FET in May.