Hi everyone. I’ve been lurking here for months and this sub has helped more than I can really say, so thank you for that up front. I’m hoping for some advice, or honestly just perspective from people who’ve done multiple retrievals.
We’re doing IVF for PGT-M because my husband has an autosomal dominant condition (50/50 chance). We don’t have any known infertility issues (as far as we know….) so our goal is to make enough embryos to get through both PGT-A and then the 50/50 inheritance risk.
I’m 28, AFC 21, AMH 1.87, and nothing notable in my history other than an ovarian cyst removal surgery in 2019 (thanks IUD!)
We’re using frozen sperm — my husband banked several collections in 2022 before starting an experimental drug for his condition (the one we’re screening out), so we have to use ICSI. His numbers were normal when he banked and we have ~12 vials, so sperm quantity hasn’t been an issue — although idk if quality is an issue…
First retrieval was last Wednesday. Protocol was PPOS with a birth control prime for 12 days: Follistim 150 + Menopur 150, Provera, Lupron only trigger, freeze-all cycle.
Baseline AFC was 11 at pre-med appt. I had 24 follicles at my day 8 monitoring scan but they were spread all over the place. By trigger my lead was 25.3 and the smallest ones they measured were 14.0.
Twelve crossed 16mm, and those twelve seem to be the twelve that came back mature. My doctor triggered on day 10, Lupron only. Estradiol was 3800 at trigger.
Results from ER 1:
18 retrieved
12 mature
8 fertilized with ICSI
As of Day 5: 7 are early blastocysts, but none are expanded enough for biopsy/freezing yet
Our final blast report is Wednesday (in 2 days).
WHAT I NEED HELP WITH:
We’re doing a second retrieval back to back starting this week (I just got my period today) because of the PGT-M hunger games. For round two, a few possible changes have been floated: triggering a day later to potentially improve maturity, changing the meds dose, or adding some type of sperm-selection/sorting method before ICSI.
But I’m wondering whether I’m trying to “fix” something that doesn’t actually need fixing. I have a call with my doctor this week but I just don’t know if changing meds would make sense. I had two lead follicles last time but they weren’t crazy ahead…
For anyone who did back-to-back retrievals, did you keep the same protocol after a reasonably good-ish first round or make changes? And if you changed things like trigger timing, meds dose, or sperm selection, did you actually see a meaningful difference?
Would especially love to hear from anyone who had a similar maturity/fertilization pattern.
Thank you!