Poor embryo quality

pozawhile

I spoke to my RE on the phone yesterday about my failed cycle.  He said that I was an excellent responder, many follies, good lining etc, but that in the end our embry quality was poor.  We had a 3 day transfer and out of 14 only 3 made it to that day and 1 was not good enough to even consider transferring.

Have you had this experience?  We have limited financial resources but this next cycle will be paid for for the most part?  Should I get a 2nd opinion?

mel72

Yes, we were also told after IVF #1 that our embryos broke apart too easily.  FSH averages around 4 - 6.  We retrieved 11, 9 mature and icsi'd, 6 fertilized and transferred a 5 and a 7 cell.  They switched protocols for # 2 in hopes of getting better quality but we had a lead follie and a bunch of laggers so we converted to IUI which failed.  I'm currently on BCP for # 3 w/ Microdose Lupron, which is what I wanted to try for #2.  We are also 100% oop now and it blows.  Best of luck to you!

Tryingtogetpregnant

How was your cycle overall? Did they start you off on higher doses of Gonal F (or Follistim) and then take you down? What were your estradiol levels? Ideally, you don't want your estradiol to be above 4000 for a cycle. 3500 is optimum.

If you can tell, I've had this experience. My first IVF cycle I started off at 300 units of Gonal F. I was bumped down to 150 and then 112 after 3 days. My estradiol got up to 5509 before my ER. Of my 19 eggs, 3 made it to a 5dt and none made it to freeze. Only 1 was an expanded blast. My RE tried to tell me I just had poor egg quality. I did get a second opinion with CCRM (#1 fertility clinic in the nation - it was an over the phone consult and cost $250). She agreed that my protocol was the problem - not my eggs.

This may not be the situation for you, but I would check into it. Start asking questions on what they're going to do to change your cycle for next time. CCRM also told me if you don't stim for at least 8 days, then you might as well cancel your cycle.

Good luck!

 

Cassian

I just went through the same thing. I stimmed way too fast and only had 7 days of Follistim. My E2 was over 4100 at trigger. We ended up getting 26 eggs, 25 mature, 17 fertilized, 5 frozen right away and out of the remaining 12, only two ended up being worthy of transfer. Transfer didn't happen due to severe OHSS so we froze. RE said it was probably my PCOS that caused the poor egg quality, but I think maybe it had more to do with my stimming. I'll never know. I don't know if i will ever do another fresh cycle after what I went through, but if I do, my RE will definitely be using a different protocol.

And 2nd opinions never hurt.

justsayjo

Yup, I had this for IVFs 1 & 2. The 2nd time around, my stim protocol was much more closely monitored, stimming for 11 days on decreasing meds wih decent E2 at trigger of like 3900 but nothing frozen and BFN although the embies put back appeared ok (not much frag). I don't know how else I'm going to get past this issue, I've already been on the lupron and antagonist protocols and am now totally oop too. I wish I had better answers, but you may want to try a 2nd opinion. I went to a new RE for IVF#2 and am considering the CCRM phone consult. But I'll wait until after my WTF appt in 2 weeks. Best of luck to you!

Million$$Baby

I had poor embryo quality as well - 7 retreived, 4 fertilized, 3 grew normally but they all fragmented horribly. RE (and the RE I saw for my second opinion) beleive that the poor quality came from my stimming. I was over-suppressed and stimmed for too long, which comprised my eggs. RE seems to have a plan in place to correct this for IVF #2 so my fingers are crossed. It can never hurt to get a seocnd opinion - I felt more confident moving forward wiht my current RE after I spoke to another one. Good luck!

trilady2

Yep, this happens to us too - poor embie quality. At first, my second RE thought I was a poor responder and compensated by using a ton of meds (300 Follistim and 150 Repronex for 10 days). Although I got better numbers of eggs, like through the roof numbers, ultimately we had a pretty poor result with very few or sometimes no good embies for transfer. I got a third opinion and was told RE #2 was most likely overmedicating me and I needed much less drug.

so the moral here is: too much drug for too long is bad, too little drug or drug for too few days is also bad. Lupron can be good for some and not for others. It's honestly up to the RE to figure out the right combo for you personally and tweak the protocol according to what works for you.

It's such a hard decision when you fall through the cracks like this - with no clear cut road to travel. I wish you the best of luck.

pozawhile

Thanks to all for the advice