Poor egg quality with pcos - advice needed

[Hopesforamiracle]

Hi- just reaching out to see if anyone has had valuable success or changes with egg quality during IVF with PCOS and currently ? Endo too!

we had 30 follicles, 17 eggs, 10 fertilised and apparently 5 made it to day 5 but we’re absolutely all awful quality with lots of missed cells. They started to go down hill from day 3. Hubby is been tested for oxidative stress and possibly DNA frag is the SOS test shows anything.

I have been put on metformin now and take like a millions supplements.

Side note my first IVF I only stimmed for 6 days as my eggs grew FAST! Then ended up with moderate OHSS and sadly ovarian torsion which lead to emergency surgery but they saved my ovary which is good! So I want to avoid that this time ideally!

I am 31 DH 32. Any advice of success to keep to going? 🤦🏼‍♀️❤️

Honestly, I took every bloody supplement under the sun aimed at improving egg quality and they still came out terrible quality. C grades. Remaining embryo was unfreezeable. I was spending over £200 a month before my ivf cycle on supplements. Very blessed one resulted in my son.

How often were they scanning you? Did you trigger with hcg?
Can't comment on the dna frag, but it may be worthwhile if you failed to produced embryos in previous round . I know it takes weeks to come back tho, so therefore fustrating.

The best you can do is eat healthy, take your metformin, definitely important as the key to improving pcos is keeping your sugars down. High blood sugars are terrible for egg quality. It's like poison to your eggs. It's not guarantee but it's definitely worth taking as studies have shown taking metformin can help reduce ohss and improves clinical pregnancy rates and reduces miscarriage risk in pcos patients. I also recommend taking myo inositol, it's basically a b vitamin and it has the same natural effect as metformin in combating insulin resistance. Its safe to take both together , in fact that's what I was recommend to do. I take 1000mg metformin ( I can't tolerate higher ) and 2000mg myo inositol. Don't take d chiro version inositol. Purely MYO form. Also recommend ALA alpa lipoic acid it also helps normal blood sugars. I think anything else aimed at improving egg quality is just a money making scheme as nothing has ever been proven to improve egg quality ( at least no independent studies that aren't paid for or conducted by the brands selling them)
But by combating your insulin resistance you can potentially improve egg quality in pcos patients.

I'm literally starting another round of ivf and this time I'm just following advice and taking a prenatal , folic and vitamin d alongside my myo , ala and metformin.
My consultant also told me to up my vitamin d as whats in the pre natals aren't enough . So I take a low dose on top . I actually take the kids drops

Were you on the metformin for 6 months b4 the egg collection or not ?

Metformin is great 4 pcos patients

I recommend taking additional vit d

Cut caffeine
Reduce sugars

Lotsa iron rich and vit c rich foods

Vit c helps reduce inflammation - have multiple sources of vit c daily.
Lotsa walks

Ivf clinic suggested wellman max
To my other half
.his results were then gd

@VioIetMoon @worldwidetravel2017 thanks both!

well this is where I am annoyed because I asked at metformin and they said because my testosterone levels were ok I didn’t need it….. this consultant has now retired and my new consultant was like yes deffo be on it and as put me on it now! He is very good and seems proactive. So before my next egg collection and stims I should have been on it for at least 3 - 4 months I would say.

I was scanned on day 5 and was pretty much ready! I then did a full stim that night, half dose day6 and just triggered day 7! Was collected day 9! Yes Ziverfert HCG trigger

i was on the zita west egg bundle but that’s like £172 a month and it obvs didn’t do much so I’ve switched to the OVUM that’s got the ALA and NAC in as well.

myoinositol 4000mg I was taking but stopped with the metformin but I might start retaking that. I’ve read a lot about the 40:1 to my o and D chiro? Why is that not good?

yeh hubby will be tested he does take vitamins but not the well man so I think we need to get him onto the established male vitamins for the full coverage and up the antioxidants on his side as well.

it’s all such a headache isn’t it and trying to hyper fixate on everything you eat, move, sleep etc!

I am trying to adapt my food to reduce my sugar intake as much as possible now and my carbs as well like trying to stay below 100g of good quality carbs per day etc

@VioIetMoon congratulations on your baby! was your son from a grade C embryo? X

Its the natural ratio which occurs in your body. However lots of new studies dont recommend d chiro as a supplement as it can have adverse effects. SOME women have trouble with the conversion but NOT all . Therfore for those women its not needed. Some women do have an imbalance but the problem is if you have a higher amount of d chiro in your body it does impact egg quality and ovulation and it can worsen pcos and it increases androgens and affects the absorption of myo . If you look it up youll find plenty of info about it. Ive had my own negative experience with it.
I dont take higher than 2000mg of myo as it can interfere with the absorption of iron ,and it can interact with b vitamins. I space it out, dont take for few hours after a prenatal.
I did take ovum last month but have switched back as it lacks quite alot lf essential vitamin and minerals.
When taking ALA look for r ala , or at best liposomal. Ovum has 600mg but its essentially useless in that form. Its not very well absorbed.

Do you have an isulin resistance?
You mentioned your androgens arent elevated. What symptoms do you have of pcos , other than the follicles on ovaries? As im assuming you have more than two of the hallmark symptoms if they diagnosed you with pcos

As well as controlling insulin spikes and general inflammation, I think you need to be on a lower dose so you can stim longer.

@sirensong I think that's where its so unpredictable with pcos. I stimmed on low dose and I still had eggs that grew very fast also. On my first scan they were already close to the mm desired for collection. Apparently with pcos that can happen, eggs can grow faster at the development point

@sirensong @VioIetMoon thanks for the replies! Sorry for the dealing my best friends just had a baby and it’s all been a bit traumatic for her so my mind has been on her.

I haven’t taken D Chrio yet only 4000mg of myo but I was going to switch. Maybe I won’t now!

yes I was thinking that about the OVUM as it has the antioxidants but not all the other bits and bobs… it’s so hard to know what to take but I feel I need to change from the egg health bundle give they were still seemingly rubbish. I do however think I’m branding myself with bad eggs before seeing is hubby has any issues soooo…

maybe I should just stick to what I was on before or a normal prenatal and add the r ALA?

the consultant has said to do 112iu meriofert and a small maybe 75iu of Gonal F combo this time but I was only in 175iu meriofert to start with so I feel it should be lower to allow a longer stim out.

yeh I’ve got the full list, irregular cycles ? pCO ovaries, hirsutism, acne and very easy weight gain.

my sugars are always normal but that doesn’t exclude insulin resistance it just mean my pancreas is still working to pump out the insulin needed which maybe a lot more than it ideally should be x

I have also PCOS and possible Endo, and took both Myo- inositol and Metformin at the same time and took a normal prenatal, plus separate NAC and ALA supplements the successful round I conceived my DC. Weirdly that 2nd round was also the one I stimmed longer for (it was 4 years ago now but in my head I think it was 15 days?) It was certainly longer than my previous round and they said they could see my eggs were better quality that time even in the lab straight after collection (I used a sperm donor so I knew it was always my eggs that would be the issue).

Impossible to know if it was the longer stim, added meds (they added a buserelin “flare” and I was also on doxycycline antibiotics) or the extra supplements that made the difference though as I changed so much that second round (as it was my 9th failed attempt if you include all the IUI’s too and I was struggling with it). I was much older than you at 40 though, so that might also be why my eggs grew more slowly.

Good Luck!

@AnneMarieWhello! Thank you for that insight. That’s brilliant and hopeful for change.

I will certainly be trying these things alongside a very low carb diet and see how it goes!

what is the flare protocol? I think mine said about doing lupron suppression and a longer stim! We will likely also implement zymot for hubby and ICSI this time round to max out our chances! X

@Hopesforamiracle I think a “flare” protocol is when they use another drug to give the main one a boost. Because of my advanced age I was on the maximum dose allowed of Menopur (now replaced by Meriofert I think). But the first round I still didn’t get great eggs so I begged the Doc for any extra meds I could add to better my chances (as well as making the decision myself to add in the extra Ubiquinol, ALA and NAC supplements 3 months before).

He suggested low dose Buserelin injections started slightly before the Menopur ones (at one point I was on 4 injections a day I think, I also did 3 trigger injections before collection!) Maybe the Gonal F combo your doctor has suggested does a similar thing? I’m afraid I don’t know much about fertility drugs.

I think at 40 and with slightly below average AMH, FSH etc results for my age, that my ovaries needed all the help they could get 🤣 You are so much younger in fertility terms that such high doses might not be necessary for you, especially with the OHSS. 🤞for you that your next round is the one!

@AnneMarieW ohhh right fair enough!!

Yes I think they will be doing the opposite and reducing my doses to the absolute lowest possible and stim for a longer time period. I had 30 follicles on the lowest dose so I think they will half the lower dose to give me less eggs but hopefully better quality ones!

weve got the dates for our frozen transfer now so we shall get through this and pray it’s the one! If not it’s back to stims and hopefully a better overall outcome! Thanks for you advice xx

Hi Ladies,

any updates on your cycles and any success?? I did our frozen in the end after 2 failed attempts for the FET due to lining issues. It took and I got pregnant but ended in a MMC. Most likely chromosome issues so we really need to buckle down and do full health and supplements for the next 3-4 months before I even look at IVF stimming again! Xx

We are 29w preg
With our baby girl

We are v lucky

We did pgta testing

@Hopesforamiracle I had a FET trying for a second child, but like yours it also ended in a miscarriage 🥲. My diet was poorer this time around with my sugars (perils of being a tired SMBC to a 3 year old!) but I did stay on the same supplements. However same as your loss, I suspect mine was also very likely due to chromosomal issues as the embryos were untested - and I’ve reluctantly had to accept DC will be an only child now due to my age. Hope you get lucky next time though and it sticks🤞

Hi there

Sorry to hear it wasnt successful. Its really heartbreaking after spending all that money on supplements to not see the result. Could I ask what's a frozen cycle and why is it needed?

I also have pcos and have just started my stim injections yesterday menopure 187.5. Not sure which stim med you were on, but after reading on here I've learnt that menopure isn't great for pcos as it can increase risk of OHSS. I'm now worried about my follicles growing too fast! It doesn't help I forgot to take my 1st injection around 9pm last night (my chosen time) as fell asleep on couch and woke up panicking took injection at 5am this morning. So this evening took it at 9pm (16hrs later) but reduced the dose to 112 (not sure if right or wrong but was too worried about over stimulation!!). Will take it strictly 9pm from tomorrow and prescribed dose 187.