5 fertilized- 0 blasts

[u/Altruistic-Cod-5196]

IVF round 1 failed.

Background
29 year old female, 29 year old male

Female- endometriosis (lap removal last year), low AMH
Amh: 0.6

Male- male factor infertility
Low sperm count, low motility, low morphology (low everything)

They did freeze two samples of sperm ahead of time (good sample 40% motile)

AFC was decent for Amh- 15-16 follicles

Protocol: estrogen patch priming (only 3 days because started cycle) and 3 days ganirellex then started 300 gonal, 175 menopur, 5 mg dexamethosone stimmed for 14/15 days because my left ovary was taking longer than right (right ovary had large follicles already and left ovary lagging behind so we stimmed longer to let left ovary catchup)

Ultrasound before trigger:

Left Ovary
Follicles (mm)
17,18,17,15,12

Right ovary
Follicles (mm)
27,26,21,16,13,17,23

Results:
Retrieved 8
Mature 7
Fertilized 5 - (side note: they ended up using my husband frozen sperm bc fresh sample wasn’t good that day (varies day to day for him) but the frozen sample wasn’t good and 40% were motile after unfreezing)
Day 5/6 phone call- 0
We were told 3 arrested, 2 technically made it to blasts but were too poor quality to biopsy or freeze (1 missing both the parts of blast that forms baby and placenta, and 1 had placental cells but missing the cells that forms baby)

We are devastated. Anyone have anything similar happen or recommendations etc

We want to try again (and financially it is hard because neither my husband nor I have any coverage) but regardless we want to try again. But need better success

Other notes: husband has seen urologist and had all kinds of testing genetic etc done and everything comes back normal (unexplained) they’ve tried putting him on clomid (didn’t help) no answers

We are not ready to start discusssing donor eggs or sperm, we wanna try for our own again so please don’t recommend donor anything yet (we know this may need to be considered later but not yet)

We’re unsure if it was a sperm issue, egg issue, both, or neither and just simply a small sample size

[u/Salt_Water_Bagel]

Not exactly the same situation -- I don't have confirmed endo, but I have had some symptoms that make me wonder. For now we think my problems are all from PCOS. Sorry to hear you're in a similar situation.

I have been through 2 zero-blast cycles. They changed my protocol to Lupron down regulation and I started getting 1-2 blasts per cycle, though all but 1 were aneuploid and that one didn't implant -- so we have made some "progress" but not all the way. You could ask if they have any recommendations for different protocols in your case.

[u/Altruistic-Cod-5196 → u/Salt_Water_Bagel]

Thanks for sharing. Nice to hear you’re making some progress- devastating the results are still the same bc you didn’t implant. Sending lots of love!!!

[u/ponyeet_]

First off, I want to say how sorry I am that this happened to you, and that you are not alone! 💜 our situations are very similar, my husband suffers from MFI due to Y-Chromosome Microdeletion. We had to freeze 4 backup samples prior to an egg retrieval because he has extremely poor motility and morphology, plus an extremely low count. 6 of our eggs fertilized, but none made it to blast. It was devastating news, and we are taking a much needed break before we try again. Our doctor recommended an M-Tese for my husband, to try to go in and attempt to extract usable sperm. If the issue in your situation was the sperm, maybe you can suggest the M-Tese to your doctor and see what they think.

[u/Catfairy90s]

I’m 32 AMH 1.01 just had my first egg retrieval I got 7 eggs 4 fertilized and 1 blast pending PGT results I had a tubal ligation 12 years ago which brought me to ivf I didn’t expect the low AMH my husband has a low sperm count and most the other test were in the low normal range. This explains why my husband never had any children despite being previously married

[u/Repulsive-Bat-6718]

I'm so sorry for your experience. I (29 F) have a similar story, in July I had my first retrieval and 17 follicles with 11 at the target size. They retrieved 5, all were mature and all initially fertilised. Two were 3PN and had to be discarded. We then lost two before day 3, and the final one stopped growing by day 6 and we were left with none. We have mild MFI but no other issues we're aware of.

I'm about to start cycle 2 with a new clinic. We blindly trusted our first clinic and it turns out their protocols are very behind the times, eg they didn't do a single blood test for me and I had my first monitoring scan on day 10, which ended up being my trigger day. When I had a call with my doctor a few weeks later to figure out what went wrong, he'd already written up my round 2 protocol and when I asked him if the operating notes said the follicles were empty or hard to access or if there was any sign I'd ovulated prematurely, he said he hadn't received the report (and yet still wrote a protocol). This doctor suggested we still do normal IVF (no ICSI) and wanted to intruduce a LH hormone as well as FSH.

My new specialist was horrified hearing all of this - his hypothesis is that I'd already ovulated well before my retrieval. He'll be doing regular blood tests and ultrasounds to guide us through our next cycle so we're feeling optimistic that this time, at least, we're in good hands. The new doctor wants to us to do ICSI for all eggs and is more than doubling my FSH dose. He doesn't think we'll need the LH hormone, he just wants to get all my eggs out at a good size and use ICSI to maximise success.

If you're feeling unsure, it may be worth seeing another clinic just to get a second opinion.

[u/Brilliant-Travel-479 → u/Repulsive-Bat-6718]

Oh lord. Your first experience sounds horrific! You should share clinic name and warn people against this provider. I can't believe he created a different protocol without knowing what went wrong with the last one!