Unexpected fertilisation failure on 4th IVF

[MeadowMouse]

Hi, I'm curious whether anyone else has had a similar experience. I'm on my 4th cycle, and each one has produced better results than the last in terms of mature eggs and stored embryos - yet in my latest and "best" cycle, zero out of 7 mature eggs fertilised.

The last 3 cycles were with a private clinic, all using ICSI, so this result was shocking and totally unexpected for us.

This is how our cycles went:

1. NHS Standard IVF- 11 collected, 7 mature, 3 fertilised, 2 good embyos transferred on day 3 (failed)
2. Private Clinic Mild IVF w/ ICSI: Cycle 1 - 3 collected, 2 mature, 2 fertilised, 2 embryos frozen (day 5 + day 3) Cycle 2 - 11 collected, 10 mature (4 matured w/IVM), 5 fertilised, 4 frozen on day 5) Cycle 3 - 10 collected, 7 mature, ZERO fertilised.

No changes in protocol, and obviously something was going right because we had so many mature eggs (for me) so this was a shock. It's even worse knowing this is so rare, and even more rare with ICSI, and rare with a good number of mature eggs, and rare when it hasn't happened previously.

We have asked a doctor to contact us for feedback and advice on what to do next. The embryologist said nothing about anything over the phone, just reported the bad news and asked if we would have a frozen transfer.

I even started wondering if they forgot to inject the sperm? Partner has no sperm issues by the way, we chose to use ICSI.

We were supposed to do a fresh transfer on what was supposed to be our last cycle, but now we don't know if we should try another cycle first or complete this cycle with a frozen transfer. I'm so stressed thinking of the huge cost of this lost cycle, and whether we can afford more. Even considering changing clinics.

Has this happened to anyone else and did you have a better outcome in subsequent cycles?

Hi there, I'm really sorry to hear about your failed fertilisation round. It's really stressful isn't it. Are you at Create Fertility by any chance?

I had exactly the same situation. First cycle of IVF, I got 8 eggs, 3 fertilised. One embryo fresh transfer which didn't take.

I decided to do a 3 cycle package. For the first two rounds at least one egg fertilised and they were frozen. The last round I got two eggs and neither fertilised. I couldn't think why! We didn't change our diet, neither one of was unwell during treatment. The only thing that might have happened is my partner has high DNA frag and I'm thinking that maybe the sperm they picked had high dna frag and that's why they didn't fertilise? The embryologist was the same with us, quite matter of fact about it - it kind of made me think it happens quite a lot at their clinic!

In the end I decided to thaw one one of the frozen embryos and transfer during my 'fresh' round. Reason being is because you get one transfer included in the cost and I didn't want to spent another £1k+ on waiting for a frozen transfer.

Are you with Create? As i noticed you had a day 3 frozen on your first cycle and a day 5 - and i know it's create policy to do that

I also had a similar cycle which was a bust - the last of 5 in the space of around 15 months - the last 3 being a back to back 3 cycle package

I do think my body had had enough by that point and it was a sign to stop. We didn't get any blastocysts from that cycle - fertilisation was awful. We decided to thaw 2 previously frozen and transferred them (and was successful and had twins)

You seem to have a good number frozen? I'd try doing a transfer and see what happens? I actually elected to put back my 2 lowest graded ones out of the 4 I had frozen (rather than best quality ones)

@ohsheglows @tiggerwhocamefortea

Yes, I'm with Create. Very interesting to hear others' experiences!

I did wonder if my body was getting IVF fatigue from 3 back to back cycles since they slowly upped my Buserelin from 225 to 300.

I am leaning towards trying a frozen transfer because my body is prepped for it. And I'm not sure yet if I can afford another round.

@tiggerwhocamefortea I'd prefer to try out my lowest grade blastocysts first, too, but they keep telling me the embryologist will decide which to use! Did you have trouble getting them to agree to it?

I’ve just finished my 4th collection in 13 months with Create and it’s been my worst to date. Collected 8 eggs, but only 3 mature and needed a day 3 transfer (the other 2 didn’t make it). Although those stats are not terrible, I always got several blasts in all my other rounds, so I think my body is either too tired of stims or has become used to them.

Embryology will pick the best based on morphology, but you should definitely ask in advance if you want to use a different embryo, they are yours after all. You might need to sign a form to say you’re going against clinical advice though. Good luck.

I didn't have any issues at all with embryology - I just said psychologically I needed to work backwards. we'd spent £35k by that point, There would be no more egg collections no more embryos so the 4 we had was it for us, and we were doing double transfers. psychologically and emotionally I needed a last ever transfer to be with our best graded. I said that I couldn't emotionally cope with transferring my AA basically and it not working and going into a last ever transfer knowing I only had lower grade left. So we agreed my day 6 4bb would go back with a day 5. Leaving my AA frozen.
My friend had also recently had to TFMR an AA embryo and I just had a weird feeling my AA I guess it spooked me a bit
Embryology was very supportive and I had several hour long phone calls with the head of embryology to talk about it - they said at the end of the day it was my choice - they could advise what they thought would be the best option but ultimately it was up to me

@tiggerwhocamefortea Those are some high grades despite there not being many, but I can completely understand why you'd want to leave the best embryos for last. I'd rather have something to be hopeful about if the first cycle(s) fail, than feel increasingly desperate as I use up the "good" ones.

I don't have any grade AAs. My best are two 4BAs and my worst is a 4CB! The 3-day embryo is a 7 cell Grade 2 so I don't have high hopes for it. That's why I was hoping to freeze some more in the last cycle.

@IslandStars Sorry you had a disappointing round. I hope things go well for you. I started IVF April this year so it's been 4 cycles in 8 months, the last 3 back to back. I was originally told that consecutive cycles aren't an issue, but it sounds like many people had more issues in later cycles.

I wouldn't worry about grades @MeadowMouse. Someone I know had 4 transfers of top quality blasts, none of them took. They then had their last 'poo quality blast transferred and that one took!

@IslandStars Did you do some of your 4 cycles back to back or take breaks?

@MeadowMouse I did a 3 cycle package, with a bleed post stopping meds in between each collection, so not exactly back to back, but they were done very closely together on the next 'normal' period. The 3rd round of the collection was my worst of the 3, but still good in that a got blasts, but my 4th round was by far the worst with no blasts, so my body definitely stopped responding so well as the cycles mounted up.

Well, we have now spoken with a consultant and she informed us that, contrary to what the embryologist told us on the day, two did fertilise, but abnormally. It would have been nice to know that up front!

She did confirm that this was a totally unexpected result for us, and extremely unusual. She couldn't shed any light on why it happened, and neither could head of embryology. We did speak to embryology separately, and he said I should take a month off before going into another cycle. I was relieved to hear that, and I am taking his advice. He also recommend an embryoscope.

I've decided to do one more cycle before any transfer, so we've scrambled together our last credit cards :( Unfortunately, this may mean leaving the family holidays early if I need a scan, and I'd probably be taking medication with me (double sob). On top of that, we haven't told some of our family yet that we are doing this, and this means we'll be forced to tell everyone, and will massively add to my stress (which the embryologist said was really important to avoid).

Still, I will try to keep positive !