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Poor embryo quality & multiple IVFs. Protocol change - what would you do?

aos4261aos4261 member
in Infertility
Hi ladies and thanks in advance for your help!  

Seeking your advice prior to my next IVF round.  For IVF #3, doctor suggesting we begin first few days w Chlomid to attempt better egg quality.   Frankly feel like we're "pulling straws" wrt medication. As y'all know this process is very consuming physically, emotionally, and financially so thoughts appreciated! 

A little about me and hubby..35 yo w FSH between 10-13, AMH 1.64 and AFC 6 each side.  Hubby is 40 w some motility and morphology issues.  All bloods (karotyping, thyroid, etc.) & uterine conditions check out fine. 

IVF #1 - Estrogen priming, 300 Follistim (progressively reduced down to 0) w 150 Menopur and Ganirelex added day 5 of meds.  HCG and Lupron to trigger.  Retreived 21 eggs, 14 mature and frozen. Later defrosted and fertilized 8 of 14 (for ethical reasons), 6 of 8 fertilized w ICSI, 1 grade 2 (12 cell, some frag) transferred d3.  Rest 2-5 cells day 3 w high fragmentation None to freeze. BFN.  Notes:
-white blood cells in hubby's sperm + lots of sperm morphological abnormalities
-although 75% fertilized, only 1 of 6 decent quality 

IVF #2 protocol - Estrogen priming, 150 Foll+150 Men, +ganx and HCG only to trigger.  Had fluid both sides by day 5 of meds so we reduced.  13 eggs retreived, 9 mature, only 4 fertilized w ICSI.  2 grade 2s (14 & 16 cell, some fragmentation) transferred d3 - BFP but lost 8 weeks.  1 day 6 3bb blast frozen.  Notes:
-sperm looked better - less morphological abnormalities
-however only 40% initially fertilized, of which 3 of 4 decent quality
-US confirmed implantation

My doctor thinks  this is poor egg quality related to age.  Suggests we move to Chlomid w later injectable, co-culture & PGS/PGD.  I am on the fence wrt another protocol change  as 1 - IVF1 is inconclusive (still 6 eggs frozen), 2 - maybe IFV #2 protocol ok (I did get PG + 1 blast, despite lower initial fert), 3 - mixed information on Chlomid (ovulate on my own each month so no issue there).  On board w PGS/PGD, but need embryos that get to day 5 first! 

I have suggested SCSA testing first and also may go day 5 transfer only at risk of cancelled cycle.  Protocol change - no clue. Any other tests or thoughts very much appreciated!



 


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Re: Poor embryo quality & multiple IVFs. Protocol change - what would you do?

  • plumeria05plumeria05 member
    Wow I can definitely relate. I'm 41 TTC for baby #1 and we've done 2 rounds of IVFs and two retrievals but embryos died on Day 5 (for both cycles). The first cycle I used Menopur and the second cycle, the dr suggested we do a mini IVF by using Chlomid and that didn't work either. We've already spent so much money and now the dr told us that my eggs have poor quality so we're better off with an egg donor. So that's where we're at, going through the egg donor procedure and let me tell you it's MORE money than I thought. It's just frustrating, overwhelming and depressing :/. Good luck to you.
    TTC for Baby #1 for 3 years. After 2 failed IUI's & IVFs, God blessed us with our miracle :).  FET 12/17/15 (transferred 2 embryos at 5days). First Beta 12/29/15 = 354. Second Beta 12/31/15 = 694. Third Beta 1/7/16 = 6,695.  Finally heard his heartbeat (126)  on 1/14/16 @ our 1st US.  2nd US on 1/21/16, HR was 159.  The most beautiful sound ever :) 
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  • aos4261aos4261 member
    Plum, Thanks for the reply. Sorry to hear about your experience but hopefully you are at peace with your decision. Best of luck to you.
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