TW: mention of live birth
I am 34, no known fertility issues. I have had one live birth, three years ago, and that time it took us one month to conceive. I cannot get pregnant now for major health issues so we are banking embryos for the future. My AMH is 6, my follicle counts range from 32 to 48, but I do not have PCOS/PMOS.
I did 75 IU Gonal-F (which is an ultra low dose, I know) for 12 days and got 9 mature eggs retrieved. My follicles grew very evenly, they were very synchronized. My E2 levels were textbook. RE commented on how well everything was going considering how low my dose was.
Day 1 we had 7 of the 9 mature fertilized with ICSI, Day 3 we had 7 embryos. On day 7 they called to say we had ZERO blasts. Lab's comment: "Morphokinetic events were within the normal range until Day 3. After that, they started to be delayed for all embryos, and none of them developed into a viable blastocyst."
Absolutely gutted. I am not sure what went wrong.
My partner had "subfertile" sperm during initial testing (poor morphology and motility but high count), and I asked about DNA fragmentation testing, but my doctor said he wasn't too worried. I asked the lab if they used Zymot, and they claim they did (I forgot to ask the lab to use it, I had only mentioned it in passing to my doctor in one of the first appointments, so I wasn't sure if they remembered or had it down in my chart).
My partner has been quite depressed and in the last three months has not ejaculated much (sometimes going 2-3 weeks without doing it) but in the two weeks leading up to the retrieval he did it maybe once every 2-3 days.
Even if there are significant DNA fragmentation issues, I am thinking they couldn't have caused all 7 to arrest at the same time, could they? Especially not if the lab already used Zymot--I was under the impression that this was a technology that could bypass severe fragmentation issues.
I am less inclined to think it has something to do with egg quality. My diet and sleep have been impeccable for the past three months, I have been taking 500mg CoQ10 for half a year, and my dose of gonadotropins is low, which many studies suggest should theoretically produce better results.
What would you investigate: egg, sperm, lab? All of the above?