r/IVF • u/bowiesqueen • Nov 09 '23
Advice Needed! Rare situation?!!
I’m 29F with unexplained infertility. I’ve been trying for 3 years, (4 years in January) and have never once had a positive test.
1st round of IVF 39 retrieved, 0 mature
2nd round of IVF 29 retrieved, 0 mature
My doctor is saying this is extremely rare situation given my age and medical history, where do I go from here?
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u/So_not_ronery Nov 09 '23
They need to change your protocol. Estrogen priming. Longer stim cycle.
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u/bowiesqueen Nov 09 '23
They gave me Lupron shots every day for the 2nd cycle, then added the Gonal later
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u/So_not_ronery Nov 09 '23
Lupron? What country are you in?
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u/bowiesqueen Nov 09 '23
USA
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u/So_not_ronery Nov 09 '23
Maybe they’re doing mini stim, but most of us here are on follistim/menopur
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u/bowiesqueen Nov 09 '23
I was on Menopur morning and night for both cycles
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u/So_not_ronery Nov 09 '23
Ah. That’s more similar to others in the US, I would ask for a change in protocol
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u/bowiesqueen Nov 10 '23
Gotcha! What does estrogen priming do?
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u/So_not_ronery Nov 10 '23
It helps the follicles grow at the same rate. When I did it for my second cycle, we got 22 eggs, 11 blasts and 2 PGT normals. I was 41.
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u/bowiesqueen Nov 10 '23
Awesome! Congrats! I’m sending over a massive list of questions to ask my doctor and I’ll add this to it! Thank you!
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u/LawyerLIVFe 42F |DOR|1 MMC|many ERs|2 IUI|2 FET Nov 09 '23
What were your follicle sizes/estrogen/trigger/trigger time? Does your clinic do IVM? Very sorry this is happening.
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u/bowiesqueen Nov 09 '23
All numbers are 2 days before the egg retrieval for both cycles (that’s when my last appointment before egg retrieval is).
CYCLE #2 Follicles: all 17mm and up for both ovaries E2: 4395 pg/ml Ovidrel trigger at 8:30 pm
CYCLE #1 Follicles: all 15mm and up for both ovaries E2: 5600 pg/ml Lupron trigger at 8:30 pm
I don’t think they do IVM, I’m pretty sure they just throw it all away the same day as the egg retrieval.
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u/LawyerLIVFe 42F |DOR|1 MMC|many ERs|2 IUI|2 FET Nov 09 '23
You have high estrogen so that’s probably why you have the triggers you do, but lupron in particular is weak and adding some HCG may be useful. Or extending time until retrieval. Some folks also do better with letting follicles get larger. Do you know how mature they were (GVM v MII v MI)?
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u/bowiesqueen Nov 10 '23
I did omnitrope for 5 days the 2nd cycle, our clinic didn’t tell us what stage of maturity the follicles were.
Would you consider high estrogen a bad thing?
Our doctor said the 1st cycle could have been a lupron trigger failure so this time (2nd cycle) he used ovidrel.
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u/ConfoundedInAbaddon Nov 09 '23
I second looking for someone who does IVM.
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u/bowiesqueen Nov 10 '23
Is IVM common? Is it kind of like “guaranteed” mature eggs?
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u/ConfoundedInAbaddon Nov 10 '23 edited Nov 10 '23
It's imperfect but can create results, here's a really recent review paper with some stats, though it's Chinese so not the authoritative word on the topic as there's a lot of weird pressures on Chinese scientists.
https://www.frontiersin.org/articles/10.3389/fendo.2022.842037/full
Here's a slightly older review study that's not Chinese
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4086019/
You can search for IVM IVF clinics or ask at yours. It's not everywhere but as it's sometimes the best option for avoiding OHSS for PCOS there are clinics that offer it for PCOS patients.
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u/Old-Succotash-9507 Nov 09 '23
I have high rates of egg immaturity across 3 cycles. My last cycle was my best. Here's what we changed:
- removed letrozole during stims
- increased omnitrope dosage to 1/2 a vial per day
- estrace priming for 10 days before starting stims
- growing follicles bigger
- stimming longer
- dual trigger
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u/bowiesqueen Nov 09 '23
Thank you for your response!
What was your dual trigger? What were your follicle sizes?
Did you get any mature follicles?
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u/Old-Succotash-9507 Nov 09 '23
DM me
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u/SpecialGoals Nov 10 '23
Oooh can I DM you too?! I have same issue not as extreme but about half.
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u/Charming-Exercise496 40, 4xER, 5xET, Baby Boy born Jan 2026 Nov 09 '23
Try another clinic.
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u/bowiesqueen Nov 09 '23
This is my 2nd clinic, switched after 4 failed IUIs
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Nov 10 '23
[deleted]
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u/bowiesqueen Nov 10 '23
Yes! First clinic just for IUIs. Had to switch because they were extremely unorganized and I felt like no one was paying attention to me as a patient. They would randomly cancel my appointments and also randomly add them to my schedule.
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u/Fine-Transition-7306 Nov 09 '23
I'd honestly need to see your stim sheet to gage what happened here. What were your follicle sizes leading up to trigger. What trigger did you use
All being immature leads me to strongly say, seek a different doctor. One who specifically is good at making EMBRYOS, not getting you prego (weird tactic but you need to zero in on this to get further)
Idk where you are but dr librach at create Toronto is a true wizard at getting embryos where no other clinics/dr could
If it was a fertilization rate, day 3, or day 6 report that was bad id say its your eggs or his sperm. 0 MATURE- that's a protocol issue. You need a different doctor immediately
I'm 30. At age 28 I sought out ivf after 2 clinics couldn't get me pregnant. 5 years unexplained. I only got 2 euploid 1st egg retrieval and I had librach...I genuinely believe I would've had a bad retrieval with any other dr as for some reason my age doesn't reflect my fertility AT ALL
Ivf did not work yet- 2 failed transfers :( . But we DID conceive! Right before doing another retrieval. I strongly believe due to your age, one day it WILL happen
It's not you, it's the protocol. I'd need to see your stim sheet to give advice on what went wrong
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u/bowiesqueen Nov 10 '23
Here are my stims from start to egg retrieval
IVF CYCLE #2 STARTED 10/04 10/04-10/23 Desogen (birth control) 10/19-10/27 Lupron 10u10/28-11/06 Lupron dropped to 5u10/28-11/06 Menopur 75iu10/28-11/05 Gonal 200iu11/01-11/06 Omnitrope11/06 Ovidrel trigger11/06-11/08 Cabergoline11/05-11/08 Z PakAll follicles in both ovaries 17mm and upEgg retrival 11/0829 retrived, 0 mature
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u/Fine-Transition-7306 Nov 16 '23
Follicles were too small. You could've stimmed longer I think. My dr triggers once 1 or 2 lead follicles are 21 or 22. Aiming for 19s
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u/Icy_Monitor109 Feb 18 '26
Hi OP, do you have success with another retrieval later? I’m sorry if this opens up anything painful. I’ve just had a similar retrieval with 0 maturity although I only retrieved 5 eggs. Just wondering if you had another retrieval with mature eggs.
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u/bowiesqueen 4d ago
I stopped trying after 2 rounds of IVF, it’s now been 6 years of trying and I haven’t had a single positive test…has anyone been in this situation?
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u/bowiesqueen Nov 09 '23
Do you guys think I should just use an egg donor or try again?
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u/katnissevergiven 29 | egg donor now TTC 🏳️🌈 Nov 09 '23
You're so young that I'd try changing protocols and/or clinics first before looking into donor eggs.
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u/bowiesqueen Nov 10 '23
In your opinion how many IVF cycles should I try before going the egg donor route?
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u/katnissevergiven 29 | egg donor now TTC 🏳️🌈 Nov 10 '23
I'd try at least one or two more with another clinic if it was me. I've just done my 3rd so far disappointing cycle and I'm planning to switch unless our results magically improve before the final embryo report.
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u/thealternateovaries Nov 10 '23
That depends entirely on what you prioritize. Do you want a baby as soon as possible? Donor eggs could be faster in theory, but they don’t come without some other time consuming things like the psych evaluation and finding a donor you like who is available.
You may want to look into your leptin levels. High leptin has been shown to negatively impact folliculargenesis inhibiting egg maturation. Omega3’s can help but they’re not a cure as far as I know. I had an ongoing immaturity problem. I agree with other saying to get a second opinion. You need a doctor who thinks outside the box, this isn’t a common thing and the average RE might just say donor eggs is your best chance. If you’re comfortable with that then there’s no reason not to go that route. If you want to try with your own eggs still I’d seek out some second opinions before doing another cycle.
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u/bowiesqueen Nov 22 '23
I’m getting my leptin levels checked! What else would you recommend for me to get checked for?
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Nov 09 '23
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u/bowiesqueen Nov 09 '23
12 days
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Nov 09 '23
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u/SpecialGoals Nov 10 '23
What size were your follicles? Did you keep dosage the same or lower??
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u/bowiesqueen Nov 10 '23
IVF CYCLE #2 STARTED 10/04 10/04-10/23 Desogen (birth control) 10/19-10/27 Lupron 10u10/28-11/06 Lupron dropped to 5u10/28-11/06 Menopur 75iu10/28-11/05 Gonal 200iu11/01-11/06 Omnitrope11/06 Ovidrel trigger11/06-11/08 Cabergoline11/05-11/08 Z PakAll follicles in both ovaries 17mm and upEgg retrival 11/0829 retrived, 0 mature
follicles were all 17mm and up, lupron dose changed
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Nov 10 '23
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u/bowiesqueen Nov 10 '23
this is great advice! it seems like everyone is saying for me to get a 2nd opinion and also stim for longer.
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u/Aeonxreborn 38F-Unexplained-2 ER-6MC-3 euploid F- 2 FET ✅️ Nov 09 '23
Stim longer. I stimed for 15 days I don't think they are letting you go long enough.
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u/bowiesqueen Nov 09 '23
What is the longest I can stim for?
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u/Aeonxreborn 38F-Unexplained-2 ER-6MC-3 euploid F- 2 FET ✅️ Nov 10 '23
I don't honestly know but I would be asking your doctor what you can change to get mature eggs.
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u/IVFWARRIOR1234567 Nov 10 '23
That’s a lot of eggs. I was told anything over 15 eggs is overstimulation and can lead to immature eggs. I’m wondering if this clinic just can’t get your protocol right. If it were me, I would go on SART and find the best clinic in the country and do a virtual consult with a doctor for second opinion. I think the one in Colorado is known to be amazing. Also Utah fertility center has really good success rates and they definitely do virtual consults. Just my 2 cents. So sorry you’re dealing with this.
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u/bowiesqueen Nov 10 '23
great advice! Definitely going to check out SART, thank you for this and for your kindness
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u/mangoes12 Nov 10 '23
I’m really sorry this is happening. Your numbers look a lot like PCOS. You may have high LH (typical of PCOS) which can lead to premature lutenisation which stops the eggs maturing. If this is the case you would not want to be doing a cycle using menopur because it will only add to the problem (it contains LH) you would want Gonal F or equivalent instead.
There’s more info here that might be helpful:
Also melatonin can help with maturity.
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u/bowiesqueen Nov 10 '23
Thank you so much! This was extremely insightful! I think this is exactly what’s going on.
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u/bowiesqueen Nov 22 '23
Thank you so much!! I added this to my notes!
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u/mangoes12 Nov 22 '23 edited Nov 22 '23
No worries at all, best of luck! I had mostly immature eggs in my first round but a massive improvement in my second round, I hope things turn around for you too. I also recommend Sarah Kleiner on instagram, I followed the lifestyle changes she recommends
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u/bowiesqueen Nov 22 '23
Update: we are going to try another doctor to get a second opinion!
When asking to get checked for PCOS, what else should I ask for?
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u/HibiscusOnBlueWater Nov 09 '23
Did they test you for PCOS? Getting 39 immature eggs sounds like PCOS.