IVF - can't make blastocysts?

[betterthingspls]

Hey everyone - new to the forum here.... I wondered if anyone else had similar experiences or advice.

We're just about to start our third round of IVF as part of a three cycle package with Create. I'm 41. In a same sex relationship and we're using donor sperm. We previously had 3 cycles of IUI with the second ending in miscarriage at 9 weeks, so we know that something works...

Our first IVF cycle got 4 eggs, all fertilised, all made day 3, and then none made blast. Our second cycle got 5 eggs and same again, all made day 3, then none made blast. The clinic are insisting on keeping the same protocol for this final cycle (300 menopur) and pushing them to day 5 again... But I feel that repeated cycles show us this doesn't work? I want to do a day 3 freeze all and try our luck with them that way. I know statistically the odds are low, but it just feels like it gives them a chance at least. I'm getting a lot of resistance from the clinic (bad for their stats?).

Does anyone have any experience with this kind of thing? The clinic just keep saying it's egg quality but I feel like some should be making blast, even if chromosonally abnormal? I suggested that some embryos don't respond so well in the lab but they insist this isn't true. Oh to have something to test!!! It's all so hard :(

Unfortunately different clinics seem to have such different policies. I was only a year younger than you when I did IVF using donor sperm as a SMBC - so I was put on the highest Menopur dose (450 iu) and they even added extra booster meds at my request for my second cycle (a Buserelin flare) to try to improve egg quality when my first cycle failed with BFN’s.

I only got 4 eggs both cycles, all fertilised but my clinic said that their policy was they would usually only culture to Day 5 if clients had more than a handful of embryos - because their experience was that the embryos would likely stand a better chance back in the body in those cases.

I think it was a pretty commonplace occurrence for older clients to only get a few embryos each cycle and their method of double transfers of Day 3 embryos gave me my only DC (via my 2nd fresh transfer - I also had an early miscarriage from a FET too but I suspect that was because most of my embryos were probably aneuploid - the main problem with Day 3 embryos is that you can’t test them and obviously the older we are the more aneuploid embryos we likely produce).

Could you at least insist they consider increasing or changing your meds to see if it improves egg quality, if they won’t do Day 3 transfers (though it’s a shame they won’t do them because afaik double Day 3 embryo transfers apparently have similar success rates for older women as single day 5 transfers if they aren’t PGT tested). It does seem a bit daft to do the exact same thing again when you haven’t had anything to transfer twice.

@betterthingspls if this is your last round I think it's reasonable to push for day 3 transfer regardless of their lab confidence.

hey, I've private messaged you with my history in case it helps! Very similar and same clinic.

@Alexandrine thank you so much for sharing this.... I had another consultation this morning and we've compromised on transferring two on day 3, and pushing the others to blast in the lab. I do feel like they're hearing me - their argument is that they're trying to avoid the pain of repeated failed transfers/miscarriages. But they did admit that there isn't much data comparing the lab to developing embryos in utero.... So we've landed on a compromise. I feel much better about it.

@sirensong agree!!! got there, kind of.

And thank you @aLogLady 💛

I would insist that they increase your medication dose. I had treatment with create that failed. They had me on the lowest dose of meds despite my Amh being low.. this was for 2 rounds and both failed.
hope it works out for you OP x