Is there any hope? Low AMH, low morphology, high DNA frag

[ohsheglows]

Ugh. I've been a long time poster in these forums but after 4 rounds of IVF and 2 failed transfers, I'm starting to feel this is never going to happen.

I guess I would feel better if it's was just me that was the issue, with my low AMH. But my husband has low morphology (1%) AND high DNA fragmentation.

We probably have enough money saved for one more round. Should I consider embryo adoption and be done with it? I feel even if we went for donor egg, because of my partners sperm, this wouldn't work either.

Instead of paying £10k for one round at an expensive place, should I pay £10k for a multiple cycle place?

We've had 4 rounds of IVF, all bar one had low fertilisation rates. We managed to get one embryo out of each round. The round where I only got 2 eggs, none of them fertilised.

I'm not sure what the purpose of this thread is. I don't have anyone to talk to about this. Guess I'm looking for someone to help process/give advice!

Hi @ohsheglows how low is your AMH / AFC and what protocols have you been on? Have you had your testosterone checked to see if it’s low?

How high is your DH DNA frag and have you seen a urologist about it?. My DH was >52.% when we went to the urologist he found a hidden variocele and when it was embolized it dropped to 25%.

I have low AMH and am a poor responder to meds. I found out my Testosterone was 0.1 and it should be 1.5-2.

In rounds 1 and 2, we got the one morula only. In round 3 after me being on DHEA and addressing the DNA frag issues I only got two eggs but both made it to blast.

@Dochas1211 thanks for your reply.

I've had 3 rounds of mild IVF and one of natural modified. I get ok numbers of eggs considering my AMH (3.3pmol) around 5-8 eggs, but on the natural modified cycle I only had 2. Most of my eggs just don't fertilise.

My husbands overall score was 37%. Dr Ramsay saw him and found a hidden infection and was treated with antibiotics. No varicocele found.

I have never had my testosterone tested! Do you mind me asking why this would be important? I do hear a lot about DHEA but have been scared to try it as you can't seem to buy this in the UK!

@ohsheglows did Dr Ramsey suggest TESE if he can’t get it down any further? There was a thread on here years ago (I’ve been here a long time!) and many women on it only got success once sperm was surgically removed. If it’s your last attempt I would push for that?

Re testosterone it’s important for egg quality. Like I said we only started making embryos once we got on the DHEA and sorted frag. I would definitely get it tested anyway. If it’s super low you’ve nothing to lose taking DHeA to get it in normal range and if it’s normal you’ve ruled something else out.

Have you clinic discussed doing a normal round of IVF too on max dose of Stims instead of natural or mild? For rounds 1 & 2 I was on low dose, round 3 max dose of 450, round 4-6 max dose of 450 plus letrozole for first 5 days. Again it could’ve been the DHEA and DNA frag being sorted but we only got embryos from round 3 onward. ( round 3 x2 blasts, round 4 x3 blasts, round 5 cancelled day of trigger due to poor response, round 6 x1 blast).

I was prescribed DHEA in U.K. without issue btw. You just need to monitor your levels. I was on it for 3 month in run up to EC and got bloods tested every month to make sure it stayed within range as too high can be detrimental too.

There’s another thing I was also considered which I didn’t do in the end due to issues travelling mid locking was PRP. Ovarian rejuvenation. It was recommended to me by a fertility expert person I saw.

@Dochas1211 no he didn't mention TESE, he just said to come back to him if the next round didn't work. I think we're going to have to see him again.

That's interesting about DHEA, I'll look into it thank you. Did you doc write out the prescription for you?

How is your IVF coming along at the moment? Have you had any transfers?

If this is your last round I would do the micro TESE. We were going to do it if frag didn’t go down. Our consultant at the time recommended it and said it wasn’t any more invasive for the man than egg collection was for the woman.

My IVF consultant wrote the prescription yes. I think given your track record if your testosterone is low you have nothing to lose trying it as long as you monitor the levels - that’s really important and some U.K. consultants are very blasé about it.

I am currently 12 weeks. My history was as follows:

1st round: 1 morula no blasts. Transferred morula BFN
2nd round: nothing to transfer
Took a break, sorted DNA frag, 3 months of DHEA
3rd round: 2 top quality blasts. Transferred 1, BFN. Wasn’t happy with the clinic so moved clinic - 1 blast left frozen there. New clinic recommended embryo banking due to poor response
4th round: 3 embryos - did PGS testing, 1 abnormal discarded, 1 inconclusive, 1 no DNA detected - those 2 are still frozen
5th round: cancelled poor response
6th round: 1 embryo. BFP

@Dochas1211 congratulations! That's awesome news. So basically I shouldn't give up? 😞

Did you change clinics or stick with the same one?

@ohsheglows I was with 3 clinics in the end. After our 3rd round we did just get aggressive with our approach - moved clinic, moved to embryo banking, new protocol, IMSI instead of ICSI, did pretty much every implantation test going before transfer and found loads of problems and got them all addressed before we put any embryos back.

That’s why I’m saying to try something new too. I think that taking sperm out surgically if you haven’t tried it is worth doing in your case and see what else you could do differently just to throw the kitchen sink at it! Especially if you’re running out of money to try.