ISCI with low eggs and low sperm help

[Lopst23]

New here. I'm 41 trying to conceive my first with husband. I have 3 children from a previous relationship which were conceived with no issues.
We have long past the year mark of trying, temping, tracking LH and every "miracle" supplement I've seen.
Got testing done recently and the results were much worse than expected.

My AMH had dropped a lot in year, down to 2.34pmol. SA didn't even measure count, morphology etc as it was so low.
ICSI is our only option and even then it may be a struggle getting enough sperm.
Consultant is also concerned that I don't have long to do this with my rapidly diminishing egg count.

The protocol was explained, 12 to 14 days of FSH injections, lots of scans and bloodwork to see how I am responding. Then trigger etc. The medication list sent however included a down regulator as well but it's on one basic list where they tick which will apply so I'm presuming this doesn't apply to me.

Has anyone done long day 21 protocol (only know the name from abbreviations on price list) without taking down regulator?

This is my time ever dealing with IVF and the Consultant was so matter of fact and abrupt I went completely blank and didn't ask half my questions.
We are now waiting a couple of months to retest sperm. I don't know how I will do it.

If I go straight to FSH injections what CD do I start? I am keen to start as soon as we get results but it should be close to AF and I know we will have further appointments before we start so I am hoping we don't have more waiting.

Hi OP,

In relation to sperm count,even if it was really low they should have some sort of numbers for you?
We have just done ICSI with very low sperm count, the embryologist said it was very low but enough to fertilise the 18 eggs that we got.

I know they can freeze sperm prior to the cycle as well as providing a sample on the day so that they have a back up? I wish we had been offered this option so that there was more choice on the day.

good luck with your journey ❤️

Thank you. All the measures were blank with a paragraph at the bottom stating in one small sample (can't remember measurement) they examined there were 8 sperm and most were unhealthy. Again I don't have the results at hand but I was expecting to see the usual, count, morphology and motility.

The consultant has said we will retest in a couple month and even if the numbers have risen we will do a few batches before ICSI and freeze some. If they are no better or worse we may need to do surgical retrieval. But both options in addition to on the day sample so it sounds like we are trying everything to get enough.
I keep telling myself we only need one good sperm per egg but I'm honestly petrified.
That coupled with the concern at how low my egg count is they aren't expecting me to produce many.
I'm trying so hard not to panic but the wait is killing me. I don't know how to not think about this for months 😭

Are you private? If you are I would ask for another consultant (or even nurse call) so that you are fully informed about your journey?

also why do they want you to wait a couple of months for another sperm sample if you have been on all the supplements etc? My partner was on wellman conception and I don’t think it did much,but I have seen others say that supplements for men alongside diet/exercise/no sauna etc does work.

I know once we had decided to undertake the IVF journey I just wanted to get going 😂

I was on short protocol,I started injections on cycle day 1. Sorry I can’t help more with the protocol but hopefully someone on here can!

Yes we are private. I have been on supplements, he has been on lots of vitamins but has started wellman and a few others as well as eating better etc.

Also they suspect as he was ill the time of the sample it may have had an affect and they've done other bloods.
I'm not even sure what protocol I am on as they didn't say other than give a cost estimate with medication.

We didn't even discuss actual numbers at the consultation and as I was so stunned by the bluntness I didn't ask. We have since got copies thought of the results.
With this clinic u don't always see the same consultant twice so I am hopeful we see a different one next time.

I really wasn't overly impressed with the consultant i know they don't give false hope but I did come away with more questions and little to no hope.
I just want to get started too. Once his bloods are back I will contact them again.
Thanks for the reply

Don’t lose hope,I think they have to be almost negative to manage expectations?!

We are severe male factor,I am PCOS spectrum but lucky enough to have a child from a previous relationship. Our initial consultation filled me with anxiety tbh but we now have 3 excellent quality embryos and about to transfer one ❤️

That is amazing everything crossed for you for the transfer. I did think the consultant was just used to giving facts and options so trying to hold on to the fact we were given options and not told it was hopeless.
I am struggling most with the waiting. I want to get started like yesterday and there is no date or plans to start yet. Nothing but waiting.
But I know it's ahead of me. Even if I am counting down the days to the next test.

Hello 😊

I don’t have any advice on the protocol etc. as we haven’t got that far yet. However I didn’t want to scroll past without saying anything.

My partner also has severely low count and at our last consultation his count was just 19 and only 4 of them were healthy. Our consultant said we need to start freezing sperm asap so we can basically build up his frozen sperm ready for treatment as there wouldn’t be enough on the day. He done his first freeze and they only managed to freeze 4. He needs to do another freeze to build up his numbers ready for when I’ll have an egg collection. We’re currently on hold with that as he’s taken it quite badly so we’ve agreed we’ll give it 3 months and he’s going to eat healthier, cut out alcohol and caffeine and I’ve also changed his supplements. I think he feels like he’s lost some control so giving him these 3 months to do all we can is giving him back some control 😊

Our consultant was very blunt also. I was in the consultation sobbing and he looked very uncomfortable 😂 I asked about waiting the 3 months and trying supplements etc. and he shut it all down and basically said his numbers are too bad and nothing can fix it. Which obviously didn’t help my partners pride. So we’ve also agreed we’ll be going to a different consultant for our follow up.

We’re now in that 3 month window and I’m hoping we can book his next freeze in for April. But if you have any questions I can try and help 😊 xx

Thanks so much! I know nothing guaranteed but it feels so much brighter than when we started out.

I would tell them you want to start asap and see what they say,if you are worried about egg quality then how much can sperm improve in 3 months and maybe better to just get it done now?

I am not the expert at all but I know how I felt when I was ready to start,we are fortunate in a way to be private and although it costs a fortune we have the privilege of convenience! Good luck with it all xx

I'm sorry to hear you had a similar experience. And now I am a little panicked that we aren't freezing immediately!
Although we didn't really have anything to freeze. We are also cutting out caffeine and alcohol as well as more supplements before the next test. Our consultant did say that even if the numbers go up we will still need a few batches for ICSI so it must be possible!
I'm sorry your partner took it badly, mine is acting like it's fine but I know this is what he feared. Although my egg count is awful too so I have been focused on that too.
We were told 8 -12 weeks but definitely not before 8. I don't think I can wait the full 12 honestly. I don't feel it will make a huge difference and I just want to get started. It is a very real possibility that we will need to do surgical retrieval anyway.
I have really struggled this week mostly since I was not expecting to be told we need to wait. Especially now after hearing how how my AMH.
I thought i would cry as well but my consultant just jumped straight into the bad news and was so matter of fact I was in shock!
I am hoping it's a different one next time. I think it will be early March when we go back. Did they suggest hormone blood tests for your partner to check FSH and LH? We are waiting on those.

I'm glad you are feeling more positive, I can't wait to be in that position.
That's what my thoughts are, how much can they change in 3 months when we have been trying for so long that it has obviously always been very low. But we didn't even have enough to freeze first time so hopefully cutting out caffeine and alcohol and upping supplements will help even a little.
We are private too and I think had our consultant not been so blunt I would have been able to question more but I sat in pretty much stunned silence other than a couple of questions.
The wait is killing me. Literally counting down days

Consultants are often wary of long protocol for people with lower ovarian reserve (also very high reserve but for other reasons) in case they can't snap out of the down regulation and AMH is further impacted. Short protocol usually starts on cycle day 2 or 3, depending on the clinic.

Fingers crossed on the antioxidants via diet and supplements - sperm can often be improved enough to have something to work with.

How far into 41 are you?

Thank you that's what I had read so I just presumed i would get the rest of the medications in the list for that protocol. Definitely will be writing down all my questions for next time.
Only just 41, I had put 41 in an older post as I wasn't far off lol.
My concern with the sperm is that consultant thinks he may has a hormonal issue as well so that would make it less likely to improve with lifestyle changes. They did say if that is the case we could move things along faster so I presume that means we could potentially start soon.
We get those results in the next few days so I've very mixed feelings about it. I think if we were both younger his issues would be addressed but the concern about my low eggs means we don't have time

@Lopst23 yes he’s done the full hormone profile and all the other bloods as we’re private and paid for them but they all came back normal. Selfishly I was hoping they’d show something as it meant we could fix it but we’re still in the unknown.

Previously he was just taking Impryl but I’ve now put him on a man’s multivitamin, ubiquinol, alpha lipoic acid and l-carnitine. Upped his nut intake and berries.

Maybe email and ask about freezing? From my understanding with such little numbers it may take a few samples. Such as my partners first freeze they only got 4 so that’s all we have at the minute. I’m hoping he’ll do another freeze in April so we don’t really know where we’re at until he does that.

My AMH isn’t massively great for my age as I’m 30 and it was 8.6. When I was 28 it was 17 so it’s literally halved which terrified me. I’m currently taking ubiquinol, vitamin D, probiotics and folate.

But id definitely email and ask about freezing! It may ease some of your anxiety. My partners first sample he had 19 sperm and his freeze they got 4. So anything is possible. X

I know what you about wanting there to be an issue. We were told a lot of the time that there is no obvious reason but then told that due to his sperm count and low testosterone they wouldn't expect his hormone test to be normal. And that if that's the case they would speed things up. I really wish I hadn't been so stunned as I wanted to question what that meant more. But hopefully the results will be through in the next few days.
They did say they will use multiple batches so I presume that means freezing what they have as they mentionned using it to back up what we get once I've had the egg retrieval.
My AMH was only 2.2 pmol. It has dropped a lot in just one year which has terrified me. My AFC scan showed 4 follicles on each side which I was told wasn't as bad as the AMH but they are concerned.