High fertilisation rate but very low blastocyst rate

[TammyinCork]

Has anyone had this problem, and what did you do that helped? I am 42 and husband is 40. We just had our first round of IVF in a top clinic in Spain and got 9 eggs, 8 mature, 7 fertilised but only 1 made it to blastocyst stage, and we are waiting on PGT-A results for it. We used ICSI and SpermSlow... It's a very disappointing result for us.

We eat very well (no takeaways, lots of healthy home-cooked food) and I've never smoked or vaped and have been teetotal most of my life. Husband doesn't smoke and rarely drinks. We have both been on a combination of supplements for the last 5 months, including ubuiquinol for us both and Impryl for him (he had mild sperm DNA fragmentation).

I have had six first-trimester miscarriages in the last seven years as well as a six-year-old son (all naturally conceived). In July, we went to CRP (Dr Shehata) for immune treatment and received a protocol for any future pregnancy, although my thyroid antibodies and TSH are now at normal levels.

sorry to hear this - similar age and similar results - first cycle 9 eggs, 8 mature and 6 fertilized. Only one made it to day 5. Second cycle we had 12 eggs, 10 mature and only 4 fertilized but ended up with two blasts and pregnant from first transfer of this cycle. It’s hard to tell if it’s male or female factor but I imagine that the lab have good equipment. I would ask for further details from the embryology team and if there was anything that they noticed. One thing that can be a big factor is caffeine or age (but it can still happen and it only takes one x)

Thank you so much, and I'm really glad you were successful from your second cycle! Did you do anything differently i.e. change protocol or diet, or even clinic? All they said was that 6 of the 7 fertilised eggs had arrested by Day 3... They hinted it was due to egg quality / chromosomal issues.

i changed clinic - my first was through the NHS and it was long protocol - short protocol seem to be better for our age group and my second cycle was short. I completely cut caffeine as it was my vice and I didn’t really know what I was doing my first cycle. I also cut out any soft drinks and alcohol and I added in a vaginal probiotic to vit d, omega 3 and Thorne prenatal. I went to acupuncture and this helped destress me as my job can be stressful. I also got really strict with beauty/cosmetics and cleaning products as I read a lot about endocrine disruptors. I used the Yuka and little bean apps to help me - Yuka good for cleaning and food products and little bean is good for cosmetics. Have your clinic offered any microbiome/immunology/sperm & egg compatibility?

I only drink decaf tea and don't touch fizzy drinks... That's a good recommendation re: prenatal! Also live very clean: only clean beauty products, no make-up, cleaning the house with natural products like vinegar and bicarb of soda etc. Been doing this for years...

The clinic do a microbiome test, which was to be offered to me at time of transfer. But I may or may not have anything to transfer, depending on the PGT-A result :-( As for immunology, they have an in-house immunologist at the Madrid clinic, but my own in London has given us a protocol to follow too...

was that clinica tambre? I was considering them but went with Therapie instead just as we didn’t have a direct flight to Madrid from Belfast and with work etc Therapie had a satellite clinic here so it caused minimal disruption. How did you find them? That sounds like you have all your bases covered but if you haven’t already, I would add in something like Optibac intimate women’s flora to supplements x

also really high fertilisation rate (only one egg fertilised abnormally) but v v poor blast conversion. Were further hurt by my low amh, so had to do a lot of rounds (5 in total, 7 if you count two rounds cancelled at egg collection). We kept getting beautiful day three embryos that would arrest post day three. That’s apparently when the combined genome activates. My partner has very poor morphology. The clinic were against him getting dna fragmentation tested but I have a suspicion this was a big factor, as the egg is responsible for the first three days, and we kept getting to day three well (8 cell, minimal fragmentation). I’ll never know. We were about to move on to donor rounds, was gonna try donor sperm first to see if my eggs did better, but for the third cycle of our three cycle package we decided to try a natural modified round which is v low stims, got one egg as expected and am currently 15 weeks pregnant. Apparently a very good egg can correct errors with dna fragmentation, so I’m thinking along those lines. I’m older, but wasn’t so old 5 years ago when we began trying.

but long story short, we got our 4AB from a low stim round and so far so good. Didn’t want to risk pgta when blasts are so precious, but had nipt at 12 weeks and all low risk. A long and difficult road, but not impossible.

Yes, Clinica Tambre Alicante - it is a stunning new facility and there are direct flights from Cork to Alicante (I think Belfast do as well?). Optibac is a good suggestion - thank you :-) How did you find Therapie?

I'm sorry to hear that you've had so many early losses. Like you I had many eggs collected with IVF - I was 39, but only ever got 2, 5 day blastocysts. I learned that the chance of live birth was less than 10% per cycle so one blastocyst per 10 eggs was about right and then there's the probability of them being chromosomally sound. I managed one live birth from about 30 eggs over consecutive cycles. At 43, it's less than 5% chance. Like you, I thought my healthy lifestyle would improve my chances but it made no difference. We want that element of control because it's so hard to accept but it's the age of the eggs that determines success. I've had egg donation now and we needed at least 5 blastocysts to give a good chance with the testing. It just made me realize how tough the odds are even with younger eggs. I wish you every success.

I found Clinica Tambre very good overall... The staff are really knowledgeable and kind, and it felt more like a posh spa than a clinic! But I did find a few issues with communication e.g. my plan said one thing about stopping the combined pill, while on a phone call from the doctor I was told something else. And I was pretty sore after the egg collection, for a week, and only started to feel normal about nine days afterwards. Does it vary from clinic to clinic?

Amazing to hear this, especially the challenges you faced with having to do more retrievals (I found doing one hard enough, but TBF, doctor's skill has a lot to do with this, and I know some women have an easy time of these). Wishing you very well with your pregnancy! Yes, some choose not to PGT-A test (and it adds a lot to the cost), but with so many MCs behind us, I pretty much have to...

Oh I had looked at the one in Madrid and not Alicante. We have a direct to Alicante but not Madrid.I know a few folks from the north that went to IVF Life in Alicante and they have been so positive about their experience . Therapie worked well for me but I didn’t have a history of recurrent loss - we just didn’t realise how difficult it would be and left it till I was +38 to properly try. Do folks with immunity concerns or recurrent loss it may not be the best but think they’re v good for straight forward cases and for folks in same sex relationships. Their stats for +38 are pretty decent. Have you considered speaking with Dr Lyudia in Unqlife in Dublin? She is meant to be very good at helping with egg quality and identifying issues

*for folks - wouldn’t let me edit

I am also 40 and my husband is 41. We are trying for another baby and its not happening for us either. We transferred our last embryo from second cycle in 2021 in November of 2024 and ended in a chemical. We decided in feb of 2025 we would try again so did a full stim and collection in april after a cancelled cycle in march and we ended up with no fertilised embryos day after collection. Then had another stim and collection cycle in june, collected 5 embryos, 4 fertilised and we had 1 on day 5 transferred and one frozen at day 6. Day 5 didnt work, then couldnt do another transfer until October because I kept having cancelled cycles. I finally had a positive test with the day 6 embryo but unfortunately had a MC at 7 weeks. Im now questioning myself whether or not its possible to have another baby and how to find the strength to keep going. I keep trying to find posts with success after 40.

So sorry to hear about your journey - I really hope you do well with the donor egg route. It really does feel like we are fighting an uphill battle, especially when living well all these years doesn't pay off. Thanks for your good wishes!

Yes, I have heard Dr Lyuda's name mentioned a number of times and may try her! A lot of the doctors actually don't know much about supplements, so it's good to find one who does. I even found this with CRP e.g. DHEA was prescribed for too long, so I stopped taking it after two months!

Yeah I think this whole area is definitely new for a lot of folks. She does have a waiting list though but her receptionist is lovely so I would call and see if she could get you on a cancellation etc and get you in contact with Ruth who is the nurse that works there in terms of what bloods you need to take. Also hearing great things about Fertylisis in Athens and I think you can do most of the tests from here x

I am 42, so 2 years older than my husband. I was still having natural pregnancies at 40 and 41 but sadly both miscarried - and now I've had this round of IVF, I wonder if these would be the same calibre of eggs that arrested on Day 3? So sorry to hear you have been down this difficult road as well. Sending you lots of strength and warm wishes, whatever you decide to do... You had a very good fertilisation rate on the last cycle, and more than one blast. Maybe an IVF clinic that does immune treatment (like ARGC, who I am now considering) might be a good next step?

@TammyinCork i have had most of the tests done and everything is fine its my amh on the lower end and quality is low, also husband has low sperm count. But i do have faith in my clinic and id say eventually we will get there it just might take a little longer.

I wish you all the luck and maybe after some extra testing everything will work out and you will find success.