Would you do Karotyping in this situation?

[EL8888]

We have done 1 round of IVF with own eggs, got 18 eggs, most fertilised, loads dropped off at day 3 and we were left with 5 embryos. BFN on the 2 mediocre ones we transferred. Other 3 were analysed: 1 arrested before analysis and other 2 were abnormal (1 complex abnormal) so they were disposed of. We then do DNA fragmentation test where the results are poor.
Round 2 was donor eggs, only 3 embryos: a 5AA, 4AB and a 3AB. New clinic reckon DNA fragmentation has improved, after lifestyle changes / supplements and sperm is excellent -we still went with MACS and ICSI. All have been transferred and all are BFN.

We are now contemplating our next move. Lining issues don't seem to be a problem -in the 11's last time. I did the aspirin and prednisolone regime. Karotyping is something that has crossed my mind, to try to rule out and sperm issues. Maybe we were unlucky with donor but l know other people who ended up with 6-8 great embryos whereas we really didn't. I think the cost is around £400 so not great but cheaper than yet another failed cycle. I would ask my clinic but they aren't as motivated as they should be, things have morphed into me telling them what to do e.g. 3rd transfer l requested Prednisolone and more progesterone. If we do another cycle, l will ask for another increase in progesterone and introduce clexane (or similiar).

Hi @EL8888 I would do Karyotyping for you both and also Y-deletion for your DH if there are sperm issues.

At this point with multiple failed transfers I would also do an ERA/Emma and Alice in case your window of receptivity is off (have you been doing all day 5 transfers?) or you have some kind of infection.

Have you retested DNA frag and has your DH seem a urologist?

I would also request a progesterone test on day of transfer to ensure it’s at an adequate level.

I tnink re donor if there are no male issues you might get 6-8 but good eggs can only carry bad sperm so far.

You can do bloods for thrombophelia too to see if you need clexane and also NK bloods to see if steroids are appropriate or if you need intralipids instead.

Oh and also test your testosterone - it should be 1.5-2 otherwise it can impact egg quality.

@dochas do we both need karotyping if we are going with donor eggs?

No not if you’re going for donor I think. Have you decided against your own eggs completely? Your own round yielded more embryos before even addressing the DNA frag issues?

That’s fair enough re extra testing.

You could ask for a course of antibiotics and then do courses of probiotics which is the treatment for bad bacteria and hope the implantation window is day 5 I guess?

Has your DH had Y-deletion tested for?

@Dochas121 the problem was the quality we got with that 1st round: 3’s, 2’s and 1’s. Our current clinic would decline to freeze 1’s or 2’s. But l suppose clinic 1 didn’t sort the sperm so well. We were left at that point with the impression it was a sperm issue, sperm cannot be improved but egg donor might improve the overall embryo. Due to my age my eggs would struggle to do that

To be honest lm tired of the IVF merry go round with the associated tests, appointments and expense. Keen to avoid any exploratory or revolutionary kind of treatments without much trials done on them.

He has not had Y-deletion test no, would that be covered with karotype? Only tests he has had are standard sperm tests and DNA fragmentation.

I wouldn't bother karyotyping - it's only going to give a result for your DH and doesn't tell you anything about the embryos your DH sperm makes with the donor eggs. You'd be better off PGS testing the blastocysts you get on the next cycle but again that's floored really

You had good egg numbers with your own eggs so surprised they suggested donor eggs so soon to you?

I'd do another round with your own eggs since you know dna fragmentation has improved

My clinic did both Karyotyping and y deletion tests (to see if some of the Y chromosome is missing) straight away when they diagnosed male fertility.

I don’t have particularly good egg quality (& low AMH) but we had drastically different outcomes after treating DNA frag

Round 1: 1 morula BFN
Round 2: No embryos
Fixed DNA Frag
Round 3: 2 AA embryos
Round 4: 3 AA embryos
Round 5: cancelled day of trigger
Round 5: 1 BB embryo

What is your DH DNA frag result now compared to before?