Disappointed with day 5 IVF update and worried about next cycle

[Magix86]

We've just had our day 5 update for our second egg collection and can't help but feel disappointed. Wondering if anyone has any advice or can share their stories to give me some hope! I'd just like to understand a bit more really. We're doing a back to back cycle to bank embryos and I'm worried about getting the same or worse results on our next cycle in a few weeks time. I want to do everything I can to get a better outcome next time or I'm afraid we might need to add a third egg collection 😒

We've used donor sperm due to MFI. I'm 39. Have been taking proceive max supplements and omega 3. No alcohol. No caffeine.
Both rounds have been short protocol, first round was ovaleap 150 and an ovitrelle trigger (NHS). Second round was 175 gonal-f and buserelin trigger (private). Same clinic. We're not doing PGT-A

On day 2/3 of both our rounds we had top quality embryos of all that fertilised and I've read the drop off after day 3 is usually due to the sperm rather than egg quality?
I've also wondered whether the buserelin trigger may have caused a lower fertilisation rate and possibly poorer outcome? I'm really not sure.

Round 1 in 2024:
16 eggs. 13 mature. 11 fertilised with ICSI.
2 x 5 day blastocysts - 1 x 4AA, fresh transfer and baby boy. 1 x 3AB frozen.

Second round just now:
16 eggs. 12 mature. 8 fertilised with ICSI. 1 x day 5 blastocyst 4BB

I'd be really grateful for any insight, anecdotes, advice for how we can prepare for the next round and anything we can maybe consider changing with our protocol or what we can aim to discuss with our clinic.

Hi @Magix86 - not sure if you remember me from the MFI thread... but definitely finding it harder the second time round. We had our son from our NHS IVF round, 4 eggs, 3 perfect embryos at day 3, we got 2 embryos a 5AA (our son) and a 4AA (no implantation).
Our next round at King's we only got 1 mature egg and that abnormally fertilised.
We moved clinic! Next round we got 4AB and early blastocyst both transferred- no implantation (had 3 excellent embryos at day 3)
Last cycle we got 6 mature eggs but only 3 fertilised (3 were soft and 1 fertilised abnormally!), we got three emrbyos 5AA, 4AB and another good grade. But we did PGT-A and no euploid.
So now I am doing duostim in July with the hopes of a euploid!
I know sperm donors have a lot of testing so not sure if it could be DNA frag from day 3?
For this latest round I used human growth hormone which can help with blastocyst development and to get 3/3 fertilised eggs to embryos felt pretty epic. I am on another thread where a poster also found it useful so although expensive (just over £1k for stims timing), could be worth a try.

Hey @TheFanciestPants I do remember you! Thank you so much for replying. And congratulations on your son 🩵
I'm so sorry you're also finding it hard the second time round. It's just awful isn't it!
Interesting you're doing duostim next - will you be starting stims again just a few days after your egg collection? I'm currently doing what my clinic call a duostim cycle although I'll be starting norethisterone on day 21 after my withdrawal bleed, so a bigger gap.

We have a follow up consultation in a couple of weeks and I do plan to ask what tests the donor sperm has, as I would assume they'd have to test it quite thoroughly. I'm also reluctant to change our donor because I'd like for my son to have a full sibling if possible. Is DNA frag just from the sperm side of things?

I'm willing to try anything at this point to get us a better outcome. I've just booked in for some acupuncture as I had this last time and thought I'd give it a miss this time but now wondering if it could help! I'm probably just trying to add something in to feel like I'm doing more. We've spent a lot of money on this for our 2 collections as need to include the cost of the sperm and the ICSI etc too! With the human growth hormone, how long would you take this for and how do you take it alongside your stims? I have heard about it but I don't know too much about it. Would it need a prescription or can you just buy it? I'd obviously need to discuss with our clinic too.

It would be lovely if you'd keep in touch with progress on your duostim round

@Magix86 aww thank you, can't believe he is nearly 2! And congratulations to you guys too. Definitely happy to keep in touch, I am finding it much easier doing IVF having a child already but still very tough!
My friend had a baby with donor sperm (as a solo mum) and she said it is an extremely rigorous process with less than 5% of potential sperm donors being accepted, so fingers crossed it was a just a bad cycle.
For duostim, I will have 3 days off then start again. I wonder as you have a lot of follicles it may not be appropriate clinically to do what I am doing ao maybe the back to back is the answer? There was a lady who had a lot of follicles precludes her from duo stim who did a luteal phase start, but not too sure on that one.
The HGH I understand means your embryos can be more likely to make blasts so if it is more of an egg issue this could help. The evidence is patchy as it doesn't work for everyone but I have had a very positive experience with it. I think the other appealing this is that it doesn't have any negative effects so it's either positive or you are just wasting money...
The doctors at my new clinic said duo stim can give better results so I am keeping my fingers firmly crossed.
Yes, for HGH you need a prescription. It is around £100 a vial and you take it each day of stims, stopping at trigger. If you are in London, Madesil in Marylebone stock it.
Sorry forgot to say on trigger, new clinic I have done dual trigger, buserelin and zivafert in differing amounts.
Wishing you all the best xxx

Thank you! I completely agree, although I am still anxious about the results I do find myself calmer this time, knowing I have my son and kind of knowing what to expect at each stage etc.
Oh really interesting to know that about sperm donors, thank you for sharing. That kind of puts my mind at ease a little. Hopefully our next round might just be the magic one 🤞🏻
Yeah it's a good point about the number of follicles maybe being a reason. Although I did just have a quick Google of HGH and I read it can work by also recruiting a larger amount of follicles so I'd possibly be a bit wary. I'm convinced the buserelin trigger didn't suit me this time and may have impacted things but we'll never know! My clinic insisted on it as I had 20 follicles on my day 11 scan and their policy is that 20 or more you have to have buserelin. I'm still feeling a little bit mad that we're paying all this money and get told we can't have a say on the medication due to their policies.
I'm going to ask if we can possibly lower my dose of stims to get a smaller amount, in the hope that we can do a hcg trigger and a fresh transfer, and also to see if slightly fewer eggs might mean better quality? Probably clutching at straws!
Did your new clinic explain much about the trigger to you and why they added in a dual trigger? I'm really hoping a duostim is the answer for you!! Keeping everything crossed for you 🤞🏻

@TheFanciestPants I forgot to tag you in my last message! I hope you're doing OK.
We got updates from our clinic today and they've agreed to freeze a 4CC and a 3BC on day 6. So at least we have another 2 although I do understand they are lower quality so not sure what the chance of success would be. I've also realised that my proceive supplements only contain 70mg of coq10! I've ordered some ubiquinol to try for our next round although it's probably a bit late to really make much of a difference now 😅

It's great you got another one to freeze @Magix86! I think the big thing is if it's euploid. Even my perfect 5AA was aneuploid last cycle so you never know either way. Fingers crossed!
I am day 8 of stims and looking at 3-5 eggs for collection so pretty standard for me really. My genetic results came back all normal so fingers crossed for a euploid this time. Seems it was just bad luck last cycle.
I have seen quite a few people on here with lots of follicles also used HGH during stims so I would say worth asking just in case. Another recommendation is melatonin, I have found it a game changer for getting more sleep and apparently it's also good for eggs.

@TheFanciestPants we aren't testing so that's another worry about whether they are euploid or not! I was speaking with my OH today about the possibility of doing a third collection this year just to bank some more given our pretty poor outcome, but it's all going to be so dependent on how the next one goes. I've heard good things about melatonin! I'll definitely ask my clinic about both melatonin and HGH and see what they say. By the time we meet with them it will only be about 4 weeks until our next collection.
Ooh day 8 of stims! How are you feeling? Great news about the genetic results, that must be reassuring. Will you be having these embryos tested?

Yeah, agreed, it's so hard to know whether to test or not. We had 2 embryos transferred from our first round this year and no implantation so we decided to check the next batch.
So that is 5 embryos this year so far that haven't amounted to anything... and our frostie from the NHS round so I completely get it. But you might be luckier than me as my clinic is 42% live birth rate per cycle, so I am definitely an outlier here and not in a good way.
I feel pretty rubbish to be honest and really worn out but I think that is because I am on 2 cetrotide each morning to stop the LH surge. Excited to get to EC!