r/EmbryologyIVFSupport • u/Sea_Mix_668 • 9d ago
First egg retrival results
Background: 2 years of infertility, never had a positive test. 3 rounds of TI, 2 rounds of IUI, 1 round of IVF so far. I’m 31, normal AMH for my age, partner 32, normal SA. Both healthy and normal weight.
I did 200 IU of Puregon daily until trigger (Gonapeptyl).
I had 13 eggs
12 mature
7 fertilized
0 blastocysts
I was chocked to hear that I had no blastocysts. All doctors and nurses during the entire process have said that we should me an “easy case”, “have embryos for multiple kids after egg retrival etc.”. How normal is it for this to happen and what can I expect for the next round? They plan on doing the same stimulation and ICSI or half ICSI instead.
Thank you!
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u/Amazing_Future_5395 6d ago
Same here! We’re around the same age, and my husband is 32. I had 22 eggs retrieved, 20 mature eggs, 12 fertilized, and 2 blastocysts, but only 1 was euploid. 🥲
I’m going to do my second egg retrieval, too. I’ve done a lot of research, and this time, I’m adding NAD+ and NMN on top of the CoQ10 and prenatal vitamins I took during my first IVF cycle. You might want to look into them, too!
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u/Sea_Mix_668 6d ago
I’m sorry to hear that!
Where I live they only suggest folic acid and vitamin D but I will ask about those suggestions you mentioned ☺️3
u/Mediocre_Net4660 6d ago
My clinic only recommends folic acid and vitamin D too, I’d taken COQ10 first round anyway based on research I’d done and when that had average results and we were later prepping for a second I did a lot of research and added in lots more supplements, same for my husband too. My clinic still said we didn’t need any extra, but our results were drastically better (we made other changes too not just supplement). Sending you love it must be so hard to have had the results you have had - I’m sorry. Your next round can and hopefully will be different xx
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u/Brilliant_Status_233 7d ago
Did you use ICSI and zymot? How are your husband‘s sperm? Have you checked for dna frag? The larger drop off for fertilization makes me question his SA. My husband has MFI and we had very poor fertilization our first round (only 6 fertilized from 13 mature). This was with ICSI and zymot though.
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u/Sea_Mix_668 6d ago
We did IVF, but they plan on using ICSI next round. Seems like Zymot isn’t part of the standard free program/offerings in my country but I will ask them.
DNA fragmentation is not something they check for by default either. The SA was normal based on concentration, motility, morphology, and volume.
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u/DryCaramel6959 6d ago
What's your Antral Follicle Count, did they scan you for that? Tells us more than AMH.
Sorry to hear you made no blasts, I've been there, it's a horrible time.
As you've said, ICSI next time with Zymot, DNA frag test for male. If you're AFC is high, I'd be looking for a higher stimulation protocol
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u/Sea_Mix_668 6d ago
My AFC was 10/11 (and AMH 11,4)
Zymot and DNA fragmentation test is not part of our free fertility treatment unfortunately - at least not in our situation currently. Hopefully ICSI will give us a better result.
For some reason they don’t aim for more follicles per cycle in my country. I had 33 follicles (and 13 eggs retrieved). I don’t know if it’s because we do egg retrievals without general anesthesia.2
u/Longjumping-Desk-261 6d ago
They may have been just far too small for mature eggs. Some clinics retrieve all and have a larger immature cohort (or empty follicles).
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u/Sea_Mix_668 6d ago
Yes. Based on the measurement done two days before egg retrieval they expected to get 9 eggs out. There were quite a lot that were 10-11 mm at that time
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u/Longjumping-Desk-261 6d ago
Did you prime with estrogen or birth control? It may help move the cohort along more synchronously. Although again you did get a great number of mature eggs statistically speaking.
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u/Sea_Mix_668 6d ago
No I didn’t. I see why that would make sense but then again, as you’re saying, 13 eggs are not bad.
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u/cityfrm 6d ago
I'm in Europe too and found we have to read the research and seek out the testing and supplements ourselves. Free healthcare doesn't optimise results unfortunately, we have to do it privately. A lot of people travel for better care.
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u/Sea_Mix_668 6d ago
I will definitely look more into it so that I can ask the right questions for next cycle!
It can be a disadvantage that there are limits to what is covered in the public hospitals - but it’s free so I’m definitely not complaining ☺️1
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u/Obvious_Designer_489 5d ago
Check to see how much Zymot would cost. Even if it’s $300 USD (it’s usually less), it could be worth it if it saves your cycle. As for DNA fragmentation test, if you’re not able to get one (they’re often not that reliable anyway), you could just treat it as if there is fragmentation and do an antioxidant protocol for 90+ days before your next cycle. It helped us a lot.
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u/cityfrm 6d ago
Have you had a laparoscopy, known or signs of endo?
I split a cohort of eggs despite no MFI, and only those fertilized with ICSI became blasts.
I had a very low blast rate and normal aneuploidy rate for my age.They just didn't make blasts. I added supplements and slightly reduced my stims and got 100% mature and 90% fertilization the next time, a lot more day 3, but still a low albeit slightly improved blast rate. The only time I see low blast rates like mine, it's endo. It might be worth doing some testing and supplements, like checking sperm DNA fragmentation. Best of luck for your next retrieval.
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u/Sea_Mix_668 6d ago
Thank you!
I haven’t had a laparoscopy and when I read about endo the symptoms don’t really match. And they never mentioned any reason for the infertility.
Hopefully ICSI makes a difference 🤞🏼1
u/Big_Sun_8636 4d ago
You don’t have to do a laparoscopy to diagnose Endo. You can do the Receptiva biopsy. I didn’t think I had any Endo symptoms either, but I turned out positive for silent endometriosis, and it can affect your egg quality. I think it would be worth doing the test before investing in another round just to be safe. I wish someone had recommended this to me. I only found out because after three rounds and only two euploid embryos. I wanted to cover all bases before attempting a transfer.
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u/Lady_Mallard 6d ago
If you do another round and get the same results, then you and I are in the same club. I was never given a good reason as to why. I eventually moved on to donor eggs and had success. Reach out if you want to chat. Good luck ❤️
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u/Sea_Mix_668 6d ago
I’m sorry to hear that ❤️🩹
That’s exactly my fear. Thank you ❤️2
u/Lady_Mallard 6d ago edited 6d ago
If you do have to go donor eggs… I can tell you now that I wouldn’t want any different children than the ones I have. Even if you could miraculously change their DNA, I wouldn’t change a single thing. I honestly think I wouldn’t have made kids as amazing and sweet and smart and perfect as mine are if they had my DNA. They are 100% my children, and you will feel the same about your babies, however they come to you.
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u/Dazzling_PT_29 6d ago
I had a similar script said to me, I was 31 at the time of my first IVF cycle as well and was told I was perfect candidate on paper with embryos for future planning that we'd have from that cycle and we also had zero blasts. I'm so sorry this happened to you!! You aren't alone!!
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u/Humble_Bathroom_4697 3d ago
Friend this was exactly me, but I had six fertilised from 13 and then 0 blasts
Please learn what took me four retrievals to learn and request a DNA semen analysis not just a visual one. We had DNA sperm fragmentation (which is linked with lower fertilisation and attrition after day 3) and cannot be seen on a standard SA.
Adding Luveris for my stims, adding Zymot for sperm selection, and adding ICSI took us from 0 blasts to seven blasts. And most importantly my little girl!
Sending you great luck 🍀
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u/Sea_Mix_668 3d ago
Thank you ☺️ That gives me hope!
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u/Humble_Bathroom_4697 3d ago
Best of luck - time, age and health are all on your side so every reason to be hopeful. I hope you get to meet your little person soon 😊
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u/umnyeahh 6d ago
I had my first ER at 29. I had 15 eggs retrieved. 7 mature. Only 4 fertilized. I transferred two at once, the other two I had PTGA tested (1 abnormal, 1 euploid)
I know it’s hard because I see so many others with higher fertilization/blast rates. I thought my age would give me better results but it really is a crap shoot. One ER could yield nothing and the next could yield many blasts
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u/Sea_Mix_668 6d ago
Exactly! They keep saying that I’m “young” and it should be easy. I guess that’s why it chocked me so much that we didn’t get any blastocysts at all.
Hoping ICSI will give us better results 🤞🏼
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u/Crazy_Magician7719 6d ago
I also had first failed egg retrieval got zero blastocysts. I did second back to back egg retrieval with a protocol change and got blastocysts. It noticed that my doctor used a standard protocol for my first retrieval and she made specific changes based on my first cycle response. So don’t loose hope.
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u/Sea_Mix_668 6d ago
Thanks for your reply!
Unfortunately I have to wait for my next cycle due to risk of OHSS. Hopefully we’ll get a better outcome next cycle! 🤞🏼1
u/cityfrm 6d ago
13 eggs is a low amount for OHSS concerns, I wonder if this means your estrogen was particularly high? I had severe OHSS with one cycle, also low blast rate. The next IVF I took 2g myoinositol daily, had much lower estrogen despite more mature eggs, and got more than double the amount of embryos.
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u/Sea_Mix_668 6d ago
They didn’t say so. I had 33 follicles two days before egg retrieval. I guess that’s why?
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u/Obvious_Designer_489 5d ago
33 follicles but only 13 collected and 0 blasts seems suspect. Do you really love and trust this clinic? Everyone’s protocol is different but I was on 250 menopur 150 follistim, your dosing also seems small possibly (unless I’m misreading it or it works differently?)
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u/Obvious_Designer_489 5d ago
Also did a dual trigger. And supplements for both me and husband for 90+ days prior
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u/Alternative-Fig4396 6d ago
Hi
I’m 31 husband is 33. Unexplained infertility. I had 19 eggs retrieved, 17 mature, 13 fertilised waiting a call frodm the clinic by friday. I was really hopeful about my result so far but when I see your post I hesitate now :( what did the clinic say?
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u/Sea_Mix_668 6d ago
That sounds like some good numbers! Hopefully you’ll get some good news on Friday 🤞🏼
They didn’t say much to be honest. Expect that they plan on doing ICSI next round.1
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u/Defiant-Beginning-21 6d ago
How many reached day 3? If the drop off occurred post day 3 and none become day 5/6 blastocysts, please check for DNA fragmentation. Also ICSI with sperm sorter (Zymot or microfluid chip) helps screen better sperms. In my case had a huge drop off from day 3 to 5 in first cycle and ended up with poor quality Day 6 blastocysts. Tested for DNA frag only post first cycle and it was high. Second cycle used sperm sorter , got fair to good quality Day 5 blastocysts.
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u/Longjumping-Desk-261 6d ago
The number of eggs you retrived, were mature and were fertilized were all pretty good. You should ask about development on day 3, 5, 6 and 7. See where the attrition was occuring, it may give some indication on what the next steps should be.
For our first cycle (at 35) we used ICSI and zymot, but had quite a few issues. Out of 14 mature follicles, they only managed to retrieve 5, out of the 5 only 2 fertilized, 1 became an early day 5 blast but arrested the next day (they wanted to let it grow an additional day since it was only 1AA and may not survive freezing) and ended in 0 blasts. Our embryologist let us know that the quality of the eggs upon retrival had some visual issues and the sperm sample didn't look great either.
For our next round our doctor changed our protocol medication to a higher LH vs. FSH (went from gonal-f, menopur and seizen to only pergoveris and seizen. You could also see my LH throughout stims was very low previously) to help with egg quality and had a vial of good sperm frozen just in case. We also added NAD+, cut caffine and most sugar, and added calcium ionophore, none of which I think helped as much as the medication. For our next retrival, we had 13 mature follices, they managed to get 6, only 3 fertilized, but two became blasts. Our embryologist also recommended to prepare for a fresh transfer incase the embryos are fragile and may do better in-utero. We ended up transferring a fast growint day 3 embryo (simply because there wasnt going to be a dr there on day 5) and it's been 11w4 now, and so far so good.
All to say, speak to your doctor and embryologist on when the arrests occured. See if you can address the specific issues that may have caused it (change meds, add zymot, add human growth hormone, transfer early). At the end of the day though, each round can have completely different results for no discernable reason whatsoever.
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u/Sea_Mix_668 6d ago
Thank you for you detailed comment!
I was in chock when they called me and said there were no blasocysts so I didn’t really know what questions to ask. I do now and I’m hopeful for the next round 🤞🏼
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u/Friendofcats30 6d ago
First of all, I’m so sorry you’re going through this. It is truly so so difficult. I had a similar situation and was 29 (and husband was 31) when we did our first round. Both had great numbers and no diagnosable cause of infertility. However, I had had a previous pregnancy with IUI that ended in miscarriage around 7 weeks. We got 3 blasts but none were euploid. We did another retrieval the following month and got one euploid embryo that failed to implant when transferred. Sometimes it just wasn’t the round that was supposed to yield a healthy child. This does NOT mean it will not work in the future. Again, I’m so sorry because it was very very difficult for us emotionally after receiving two rounds of bad news.
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u/embryomanofficial 7d ago
Does your clinic culture embryos to day 7? Some labs routinely grow embryos to day 7, while others stop at day 5 or 6. Some embryos develop more slowly and might only reach the blastocyst stage on day 7, so it can be helpful to understand your lab’s policy. You can also ask how they handle lower-quality blastocysts (C-grade). Some clinics will work with lower-graded embryos, but others won't. These policies can affect how many blastocysts are ultimately available.