Advice needed - Poor response despite decent follicle count (IVF)

[ThreadWalker]

Hi everyone,

I’m looking for some advice or suggestions regarding our IVF journey so far.

We tried naturally for two years without success, and started IVF a few months ago. We’re currently in our third cycle (egg collection should be this week). Our first two cycles were short protocol, using Meriofert and Fostimmon. For this third cycle, we’ve moved to a different clinic and are now on Menopur and Gonal F, with added growth hormones.

Each time, the follicle count during stimulation looks reasonably good (usually between 10 and 15 follicles seen on scans), but only a few actually grow properly and are mature at collection — we’ve ended up with just 3 mature eggs in each of our first two cycles. Unfortunately, the current cycle seems to be following the same pattern so far.

We’re feeling a bit stuck and wondering if there’s anything more we can do to improve the response — to get more follicles actually maturing? Has anyone been in a similar situation and found anything that helped?
Any advice, suggestions, or even personal experiences would be really appreciated.

Thanks so much in advance!

Hey @ThreadWalker sorry you've had a tricky time on your cycles, it's so disheartening. I had a similar situation in my 1st cycle that despite a good number of follicles not as many grew as expected. I changed meds, to menopur, and they also put me on highest does they do (450), presumably they've already increased your dose but could it be higher still? I was also going to do double trigger of buserelin and zivafert to get more mature eggs but in the end just did the buserelin after some blood tests. Your clinic will of course know far more than me, but just to put in my 2 cents! I didn't get loads more eggs in the 2nd cycle but got more mature eggs so that helped

Hi @Orangewillow Thanks so much for your reply — it really helps to hear from someone who’s been through something similar. Yes they increased the dose for my second cycle but results were even worse (only 2 fertilized eggs and they didn't develop well). It is a bit frustrating as I was hoping that there would be some solutions for that kind of issue but maybe it is not that common. The new clinic mentioned estrogen priming which could potentially help but the first one didn't even mention it. Not sure how helpful it could be.

Hello. I’ve been watching this thread as it’s very similar to my situation; I’ve only done one cycle so far though. I had 7 follicles, 5 eggs but only 2 of those mature; both fertilised but only one suitable to transfer.

In our follow-up with the clinic they were baffled; apparently I was on the highest dose already and with my AMH they would have expected to get 12-15 eggs. They could see no reason it didn’t work and said they’d do exactly the same next time which I don’t find very reassuring. The only suggestion they could make for it not working was that I was too stressed…really helpful :/

Sorry that’s not helpful but just to say I’m in the same boat and would also be grateful for any information from someone who has overcome this. :)

Hello @YourTipsyDog did you have a monitoring cycle before your IVF ? If yes how many follicles did you have ? Across our monitoring + IVF cycles we have seen the number of follicles changing quite a lot (lowest was 8, highest was 16). There was no particular reason, each cycle was just different. So there is a fair amount of randomness in the process. 5 eggs out of 7 follicles does not sound too bad but 2 mature out of 5 seems a bit low. My new clinic suggested estrogen priming to improve the synchronization of the follicles. Did your clinic mention it to you ? Also it looks like some clinics recommend to do a long cycle to improve the synchronization. I asked our doctor but he doesn't like it as there is a risk of over suppression which could make things worse. One thing which really surprised me is that different clinics can have very different approaches and recommendations. My first clinic didn't suggest anything in my case, for them it is what it is and nothing can be done. My second clinic at least had some suggestions to try to improve things.

Hello, thanks for your reply. We didn’t have a monitoring cycle; I can’t imagine this is offered for NHS patients? (We only had one NHS round which we’ve now had, as well as the frozen cycle we should have had because we had no embryos to freeze).

It’s worth speaking to our clinic about those things but so far they seem to be of a mindset that it’s a numbers game. One of the Doctors we spoke to said that there’s no point doing any tests because the solution to any problem that we find will be to do IVF.

While we could consider moving to a different clinic, we then have to start everything all over again (various tests, paperwork etc) and I’m not sure I’ve got it in me…sigh 😅