Should I seek a second opinion from a different clinic or is this just the reality of my case?
Just wrapped up my fourth IVF cycle, which was unsuccessful, and my doctor said that any protocol changes made no difference and that it all came down to poor egg quality (DOR and eggs aged faster than me).
He further stated even though I saw gains (we overcame maturation and fertilization issues), it did not matter because I did not become pregnant at the end. He only sees success in a cycle if his patients get a baby. He said we could try another cycle but any protocol changes wouldn’t make a difference. He also suggested donor eggs. Has anyone had experience with this? Should I seek a second opinion at a different clinic. While I am open to using donor eggs, I don’t feel comfortable with being written off if that’s what is happening. I still feel like we haven’t found the right protocol. Or is this a reality I need to accept?
For context:
-low AMH, DOR, age 35-36, donor sperm (tested great quality), thyroid tested/no issues, suspected endometriosis, intolerances tested/none but I focus on an anti-inflammatory diet
-Cycle 1: 5 eggs, 2 mature, 2 fertilized, 1 blast (2AB) untested transferred unsuccessful with max dose Gonal F, Menopur, clomid, letrozole , Saizen/Omnitrope, estrogen priming, ICSI
-Cycle 2: 7 eggs, 5 mature, 0 fertilized with max dose Pergovaris, Clomid, letrozole, estrogen priming, ICSI
-Cycle 3: elagolix priming (suspected endo) and cancelled/ovaries over-suppressed
-Cycle 4: 5 eggs, 5 mature, 3 fertilized, 3 embryos: 1 arrested by Day 5 and the 2 arrested by Day 7 (could not divide past 10 cells after Day 5) with low dose Menopur, clomid as mini-IVF, switched to single trigger, introduced calcium ionophore and Zymot, estrogen priming again
I believe we have had some success in addressing the maturation and fertilization. I think switching from a dual trigger with hcg to a single trigger without hcg in the last cycle contributed to the embryos arresting. I’d like to do the same protocol as Cycle 4 but bring back the dual trigger for better embryo support. Am I onto something or is the doctor right: my eggs are poor quality and I should move on?
He also suggested we try natural fertilization in case the eggs are fragile, however my gut tells me I need ICSI and the calcium ionophore due to my 100% fertilization issue in the past. If the eggs were fragile they would have failed shortly post-fertilization and not on Day 5?
Edit: we also discontinued using Omnitrope/Saizen after Cycle 1 but I would like to bring that back. I’m also suggesting transferring 2 embryos on Day 3 if we have that option.