# Embryo freezing



## anna8 (May 10, 2015)

I'm a 38 year old single woman. In July 2015 I went to Cyprus to freeze my eggs following IVF and this resulted in only 4 frozen eggs. I was told I had a low ovarian reserve and advised to take DHEA supplements for 3 months then try again. I was also told embryo freezing would be a better option. The only problem with this is I have to choose my sperm donor now, so if I meet someone later the child won't be his genetically.

Recent tests reveal I have low AMH, low AFC and low vascularity.

I had a consultation with a Clinic in London to enquire about Embryo Freezing using donor sperm. I was told that there were 3 choices prior to egg collection:

•	a natural cycle (with no fertility medications) which has the potential for better quality eggs
•	mild IVF stimulation (which encourages the production of eggs and in my case would result in approximately 3 embryos)
•	a Natural modified cycle with tamoxifen ( which I was likely to result in fewer eggs but of a better quality)

Does anyone have opinions about which is the best option?
Due to the costs in the UK I cannot afford to get the treatment here. I also found it extremely frustrating that there were so many hidden fees that I was not made aware of until after my consultation.

I was also told that there were two ways of fertilizing the egg with donor sperm:
•	IVF (50-60% success)
•	ISCI (80-90%)

I would like to hear from other women who have frozen embryos to successfully use a few years later or even one year later. Is embryo freezing really a viable option if I want to wait 1 or two years before embryo transfer? I feel like the clinic just want to take all my money so that's why the told me it was a good option.


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## Blondie71 (Oct 26, 2011)

Hi Anna, I'm single & my boys are from a frozen embryo in 2012 (embryos were frozen approx 6 months before I had FET and I still have 5 more frozen should I wish to try again as they can stay frozen for up to 10 years) I know you are concerned about your possible future partner not being the bio dad but realistically you won't probably be able to have your own bio child if you wait given that you know you have a diminishing reserve that is declining rapidly, I would go for the tx that will give you the best outcome and I'm not sure which of the 3 will suit you tbh as I had a max stim tx, hopefully someone can advise, but yes embryo freezing really does work!!!


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## anna8 (May 10, 2015)

Blondie71 said:


> Hi Anna, I'm single & my boys are from a frozen embryo in 2012 (embryos were frozen approx 6 months before I had FET and I still have 5 more frozen should I wish to try again as they can stay frozen for up to 10 years) I know you are concerned about your possible future partner not being the bio dad but realistically you won't probably be able to have your own bio child if you wait given that you know you have a diminishing reserve that is declining rapidly, I would go for the tx that will give you the best outcome and I'm not sure which of the 3 will suit you tbh as I had a max stim tx, hopefully someone can advise, but yes embryo freezing really does work!!!


Thank you for your response. It really has helped me decide what to do. I'd love to hear from more single women who have had babies from FET.

By the way Blondie, did your FET work first time? May I ask how old you were when you froze your embryos?

Thanks: -) 
Modified: sorry I just saw your age at the bottom so I guess you were about 40 when you had the embryos frozen?


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## Blondie71 (Oct 26, 2011)

Hi Anna, I'm def not the only singlie that had FET so I'm sure somebody else will respond soon - weekends are VERY quiet on these boards! Yes I was 40.5 when I froze them and I froze due to needing my tubes removed after stimming flared up hydrosalpinx, 1st FET worked after tubes removed   You really do have plenty of time to meet a man but unfortunately not so much to have a baby so you'll have to prioritise x


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## scarletlipstick (Sep 29, 2015)

Hi Anna,

I'm 34 and last month froze embryos with donor sperm. This seemed to me the perfect option as I'm not ready to have a child just yet (choosing to wait a year and change jobs slightly). I suppose if I meet Mr Perfect in the next year I also have that option. But for me I might meet Ms Perfect and then I'll be delighted to have them or much more likely I'll still be me myself!
Plan is to transfer the first one Nov 2016. xxx


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## Tincancat (Mar 19, 2012)

Hi Anna 
I had 4 eggs frozen in my 30s and although they formed good embryos they didn't implant.  I wish I'd frozen embryos instead.  If you want to try for an OE child then embryo freezing is definitely the way to go.  if not double donor is an option which is how I got my lovely boys.
TCCx


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## janieliz (Jul 25, 2014)

Hi,

I haven't frozen embryos myself, but I know a couple of single women who have done embryo banking but are yet to have them transferred. I think it is pretty common now and is a good option if you don't feel ready to have a fresh transfer. Freezing embryos is much more successful then freezing unfertilised eggs. With regards to the low AMH stuff, it means that this could be a longer process as you won't have as many to freeze - but depends on your AFC and how you respond. My understanding is that clinics like to freeze blastocysts, so say if you only get between 2 - 4 eggs at collection then you may only have 1 - 2 embryos to freeze - however, they should be of good quality. I had a rubbish AMH, antral follicle count, high FSH and I did a low stim cycle in my natural cycle, I got two eggs and two blasts on the first cycle to transfer, and then I got 5 eggs and 3 day 3 embryos transferred on my last cycle and I am pregnant with a singleton. FET's have a good success rate if the clinic has good vitrification techniques. Personally, if it was me and I do have low AMH and very few eggs, I would look abroad to have this done. It is much cheaper and means that you can have more cycles and bank up more embryos. A fellow FF friend with low AMH banked 8 embryos over a year long period I think.

x


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## scarletlipstick (Sep 29, 2015)

Also Anna just to echo what Blondie says - I know it can be tough to hear but at 38 even if you meet your partner this weekend (and you never know!) and you knew each other for maybe 6 months to a year before TTC the chances of having a child that is biologically both yours and his is quite small. You will see from these boards that lots of women in the 40+ group end up moving to donor embryos (by no means all though it is true). 
That was part of my figuring at least - also if he really is meant to be he won't mind!
Scarlet x


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## natclare (May 27, 2011)

Hello, As you can see from my email signature I started out freezing eggs as an egg sharer and moved on to freezing embryos. Initially the whole concept of donor conception was not something I could accept which is why I started out with the eggs. I subsequently did 3 cycles to freeze embryos and as a result have 5x day 1 embryos in London from 1 cycle and 7x blastocyst embryos in Athens from 2 cycles. When I started freezing I was 34 and I completed everything a month before my 36th birthday. I have until I am age 50 to use the embryos apparently but I expect to start working my way through my frozen embryos around September/October 2016. I don't to be quite honest hold out any hope for the eggs but I have a few there if I need them. I am still meandering around in the last chance saloon of dating and hoping against every diminishing hope that I may find my husband - ha! - but not looking terribly likely and at some point I need to draw a line under the looking for a husband thing. I do want to make sure I explore every possible avenue before I go back for the embryos. I am very focussed however on having a family but equally terrified at the same time. One reason I moved to Serum in Athens was money and the cost of treatment, but also because they froze blastocysts. Mine are day 5 grade 1 blasts so I think the thinking is that these are better than those frozen on Day 1 as already pretty robust. I can't really advise you on which method of IVF etc as I simply went with regular IVF so get as many eggs/embryos as possible. Wishing you all the very best of luck. x


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## anna8 (May 10, 2015)

Thanks for all the replies, it would be great to hear more stories if you have them! I'm fairly new to all this and am still confused by terminology such blastocyst embryos, so I'll have to do some more research. Initially I was focused on freezing eggs, but since I only managed to freeze four eggs on my first cycle in Cyprus I decided freezing embryos would be wiser. I was told I would need about 20 eggs to do any good.

Does anyone know how many embryos need to be frozen to have a good chance of conception? I guess I will have to do a couple of cycles to freeze enough.

I'm assuming that doing a fresh transfer has a higher chance of success than doing a FET, but have not found much info on that. Can anyone advise me? 

I'm very confused at the moment because different friends and family are telling me to do different things. Some of my friends say I should wait for Mr. Right and do things the natural way but I don't hold out much hope for finding him or even getting to the stage when he's ready to have children, by which time it may be too late. My sister in law thinks I should not even freeze my embryos and I should just have a fresh embryo transfer now. She asks why I'm even waiting if I know I want a child. 

The problem is of course money, I worry if I have enough saved to raise a child alone. I do have some savings but not a massive amount. My sister in law says that lots of people have babies with no money, so I guess it's not impossible. I don't really know what to do, but if I had a fresh embryo transfer at least I would know if the treatment had been successful and if it's successful I wouldn't be wasting money on further embryo freezing procedures!

I have signed up to a dating website but I'm putting in a rather half-hearted attempt to find a man. I feel too obsessed with babies to behave in the carefree manner which men seem to find attractive. Obviously I don't want to scare men off by telling them about my obsession with a having a baby on the first date or anything but it kind of feels like lying by omitting it.


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## deblovescats (Jun 23, 2012)

Anna
I can totally empathise with your situation and I think you're very wise to consider it. I know it's hard to come to terms with, but fertility declines very rapidly after 35. I had always hoped to find Mr Right in time to have a family, but as he didn't come along, I knew time was ticking away and my chances weren't great. Embryo freezing is much more successful than egg freezing so you'd have more chance of success if you did this. Unfortunately, the chances of meeting a man in time to have a child with him, isn't great, but if you had donor sperm and tried with your own eggs, you'd be able to go for it later on and if you met a great guy who you wanted to settle with, he'd have to accept that if he wanted a baby with you, this is the only option. I was 45 when I tried as a single woman but went straight to DD due to my age - wanted to maximise chances of a baby and obviously funding it myself, cost was a consideration. I had one attempt with fresh DD then a FET with embryo from same cycle - both BFNs. This was at a clinic in UK, and I wasn't happy with the limited follow up. Had a break and then went to a different clinic in UK - had DD and amazingly got a BFP - this resulted in DS who is now 15 months old. I love him to bits, he's the light of my life and have never regretted going down this route. I've had to get my head round the fact that it's double donation so if I met a guy, DS has no genetic link to either of us, but I totally don't think about that. I have 3 frosties and am planning a cycle in November to try for no 2! I'm still hoping to meet Mr Right, but I knew that if I didn't go for it now, I'd regret it. If I do meet someone, he'll have to accept we come as a package! 
Just to clarify for you - blastocysts are 5 or 6 day embryos, so they are further on developmentally. Clinics like to let embryos develop to this stage if they're looking good at 2-3 days. If they look as if they might not develop further in the lab, the clinic will advise implanting them at 2-3 days. If you have good number of embryos as well, they're more likely to suggest letting them develop to blast stage, as if they dont' develop further you've lost a few. However, the pregnancy rate is increased with having blasts implanted so clinics are more likely to suggest just implanting one. Blastocysts are more likely to be able to be frozen. The clinics freeze embryos initially for 3 years but you can then pay to have them frozen for longer. I don't think how long they are frozen has an impact on success, it's how they thaw out. The nurse at my clinic said they'll thaw one first, as they were frozen singly, and if that thaws ok, will leave the other two frozen so I have that option of further treatment with them. DS was the result of an expanded blastocyst, which evidently has a few further cells than straight blasts. I had 12 eggs from donor, all fertilized, it resulted in 4 embryos to use, all blasts.
Don't know if this is of any use, but I'd recommend you go for freezing embryos now, then you can decide when to go ahead. You could always go down double donation route later if you have no success with OE.
Good luck
Deb


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## janieliz (Jul 25, 2014)

I can only speak from where I am at the moment, I was 35 when I first started thinking about having a baby by myself. I did online dating for about 6 months and quickly came to the conclusion that I was too desperate to start a family, but was just not meeting anyone that I liked. I had a fertility MOT during this time and got the news about low AMH and high FSH and learned my ovary had been removed - I did not know that it had, long story.
It took me another 6 months to summon up the courage to do something about it. I moved back up north where I could afford to build a life after a move back home to London and then started treatment. I felt like a woman possessed and knew I did not have much time given my ovarian situation. I knew that this was the path and nothing was going to deter me. I totally understand the wanting to meet someone but I felt like I had the rest of my life to do that and actually the online dating had really put me off, particularly as most of the people contacting me where in their 50's!  
I think what I am trying to say is, if you are unsure, go with the freezing of embryos. FETS are near enough as successful as a fresh cycle these days if you go to a good clinic. Once I had made my mind up, nothing was going to deter me. I was incredibly single minded about it. If you are not there yet, you are not ready, give yourself an insurance policy with embryo freezing I would say!


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## anna8 (May 10, 2015)

Thanks for all the replies. It has helped me realise that I am definitely doing the right thing by freezing my embryos. It's true that I have the rest of my life to find a life partner but I don't have the rest of my life to have a baby. I plan to freeze my embryos and will hopefully do a transfer in 6-12 months.


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## Blondie71 (Oct 26, 2011)

I'm not sure there is a magic number of embryos it's a case of finding one or 2 that are good! In my own case I had 10 embryos suitable to freeze (ran into problems with my tubes so fresh wasn't an option) I had 5 thawed and 1 was no good so 4 were put back and only one took but split into my twins, I still have 5 frozen if I wish to try again  

Fresh or frozen If you choose a clinic with excellent vitrification your chances should be same   my boys are from a 3 day FET so if the egg takes it takes   Don't get too hung up on stats but do choose your clinic wisely x


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## Blondie71 (Oct 26, 2011)

Oh and regarding money, will you ever have enough?? If it came down to that the population would have died out long ago x


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## anna8 (May 10, 2015)

Blondie71 When you say 4 were put back does that mean they put 4 embryos into you for your FET? Do they usually put more than one embryo in for FETs? Sorry I really don't know much about them and for some reason they would only put one in and that if it failed I would just try again. Thanks


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## scarletlipstick (Sep 29, 2015)

Hi Anna,
As you can see from my signature I have 9 blastocysts in the freezer, planning to transfer one at a time also. And all being well I plan to have the first one put back in about a year, so we might be cycling together!
Scarlet x


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## Blondie71 (Oct 26, 2011)

Haha if you go abroad they will put back more, I had 4 because I was 40 and that was the legal max for Greece, I was very nervous about it tbh as I wasn't sure how I'd cope if all took but realistically 4 OE taking in a 40 year old is highly unlikely and as it turned out only 1 out of my 4 took so I don't regret it at all.

In UK you'll only have 1 put back unless you have multiple failures and they MIGHT suggest 2 x


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## anna8 (May 10, 2015)

Blondie71 Ah I see. But theoretically if they put back more than one does that increase the chance of twins or triplets?

scarletlipstick Oh that's' great I think I need to freeze a few embryos first, it sounds like you have quite a few already!


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## Blondie71 (Oct 26, 2011)

Well yes it does as you're playing with higher stakes but I calculated my age as being the thing that would be the decider and the chips fell in my favour as I expected, if those were donor eggs or I was under 35 (maybe even upto 3 no way would I have taken that risk!


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## Rosalind73 (Apr 25, 2012)

Hi Anna,

I think that for over 35s it's pretty normal to transfer more than one embryo (even if blastocysts), and if you are over 40 you are even allowed to transfer three in the UK - although I think it would be pretty unusual to transfer 3 blastocysts.

Re when is best to freeze embryos - my UK clinic (the Lister in London) told me if you are planning a "freeze all" cycle that it's better to freeze embryos on day 1. They say they have the same thawing rate as blastocysts, but apparently once thawed, pronuclear embryos (day 1 embryos) behave exactly like fresh embryos, so in other words they have the same potential to implant (whereas thawed blastocysts apparently don't have quite have the same potential as fresh ones, particularly if they are more fragile (i.e. they are of a poorer morphology). The only disadvantage of freezing at the pronuclear stage is that you have less info about how many potentially viable embryos you are going to end up with. But as a rough rule you can expect most day 1 embryos to make it to day 3, and then about 30-50% of those to make it to blastocyst stage.

Historically there has been a bit of debate about whether embryos are better off in the womb or in the lab after day 3, but the consensus now seems to be as long as a clinic has a good lab, if an embryo doesn't make it to blastocyst stage in vitro it wouldn't have done so in the womb. Typically if someone is having a fresh cycle, taking embryos to blastocyst stage is a selection tool. So if you are planning to have 2 embryos transferred, and you only have 2 on day 3, then you might as well have them put back then, because no-one is yet saying (as far as I know) they will do better in the lab than in your womb. However if you want 2 put back but say have 6 embryos on day 3, then the lab won't know which ones to choose as at that stage - it's very hard to assess their potential as they are still only a few cells (ideally between 5 and 8, although women have had live births from day 3 embryos that are 2, 3 or 4 cell...the point is they just don't know at that stage). But by day 5 or 6, the weaker ones will have given up the ghost i.e. natural selection will have taken place, and in addition the lab will be slightly better able to assess the potential of the remaining embryos.

However you need to bear in mind that even at that stage they still cannot truly assess quality - as Professor Winston explains in this article, they can't see the DNA or know whether an embryo is chromosomally normal:
http://www.genesisresearchtrust.com/ivf-and-other-answers/embryo-quality

So even an embryo that is supposedly "top grade" may well be chromosomally abnormal - and this is the greatest challenge for older women as most embryos don't implant or will later miscarry for that very reason (only 20% of embryos are chromosomally normal for the average 40 year old). The only way round this is to have your embryos genetically screened using a technique known as PGS. Or to have more embryos transferred (if you have them) in the hope that at least one is normal.

I agree with everyone that it's definitely much much better to freeze embryos than eggs. Eggs have a very high water content and even if frozen with the very latest technology may form ice crystals that damage their structure. Whereas embryos are much more robust.

Again I echo others in that with a good clinic, FETs are fast becoming almost as successful as fresh transfers - in fact the thinking is that for some women their endometrial lining may be better (and more receptive to implantation) with a FET, when they haven't undergone the process of stimulation in order to try and get as recruit and grow more follicles/eggs than you would naturally. Interestingly one of the biggest clinics in Japan now only do FETs rather than fresh cycles.

You can ask potential clinics what their stats are for FETs compared to fresh transfers, but note they aren't comparing like with like. At the moment most cycles and transfers are fresh and thus use the better graded blastocysts - which although may or may not be chromosomally normal, are more likely to survive the thaw and have better potential to implant than those of a lower grade - whereas it's the surplus (and lower graded) embryos that are frozen. Although as mentioned above, the way embryos are graded is often very misleading, so must diminish this effect a bit i.e. it might be a higher graded chromosomally abnormal embryo that is transferred in a fresh cycle with a lower graded but chromosomally normal embryo being frozen.

And that is one real reason why fresh can be better, because by putting a chromosomally normal embryo that has slightly poorer morphology through a freeze, you run the risk of it not thawing properly and reducing it's potential to implant, which wouldn't be the case if it were transferred in a fresh cycle. So even the top clinics (with the best labs) are likely to say they do better with fresh cycles, even if they are extremely good at freezing and thawing embryos.

NB you should also ask what their thawing rates are, and if they are lower than about 95% for blastocysts (or pronuclear embyros) then you might well be putting yourself at a disadvantage by having a FET with them. Note the 95% or higher figure only applies to embryos of a certain grade.

It's complicated isn't it! But we're all here to help and advise if you have any questions. And I'm happy to chat if you want to talk things through (just send me a PM).

Good luck with whatever you decide to do.

This post contains an unconfirmed link/information and readers are reminded that FertilityFriends.co.uk or its owners are not responsible for the content of external internet sites


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## Rosalind73 (Apr 25, 2012)

Hi - one more thing - if you don't mind me asking, what is your AMH, FSH and AFC? What dose of stims were you on and how many days were you stimulating for when you produced 4 eggs?

The reason I ask is that there is no real evidence that higher dose stims directly impacts on egg quality (the US has one of the highest success rates in the world and generally uses higher doses).

The point is more that if you have a low ovarian reserve, there is a cut-off point above which using more stimulation (higher FSH doses) will do jack poop. There is simply no point using higher doses of drugs as you won't produce more eggs and it's obviously better to keep things as close as possible to what would happen naturally if you can (e.g. so your lining is more receptive). However if you do use higher doses, it doesn't necessarily equal bad egg quality. 

As explained to me by a fantastic embryologist, rate of egg maturity is extremely important. An egg needs a certain amount of time to develop properly and generally 6/7 days of stimulation is not long enough, however if you stimulate an egg over 10/11/12 days you will get egg maturity. He likened the process to producing a car too quickly and selling it without any brakes. So what can happen with some women is that they if they use higher doses of drugs, they might stimulate too quickly. And here's where the confusion lies - in those cases there might be an association between using higher doses and poorer quality eggs, but it's not causation, i.e. it's not the drugs themselves that are causing the poorer quality eggs, and for very many women higher doses of drugs are fine.

It's only anecdotal, but in my case I produced a chromosomally normal embryo on a 300IU cycle, no chromosomally normal embryos on a 350IU cycle, and on a 450IU (with 12 days of stims) I produced no more eggs than previously, but a chromosomally normal embryo (which I'm now pregnant with).

People might say they had better graded embryos with lower doses of stimulation, but a) as mentioned the way embryos are graded only really tell us whether they are pretty or not! E.g. I've had supposedly top quality blastocysts (2AA and 3AB) or a good quality blastocyst (4BB) that turned out to be chromosomally abnormal. Although just to complicate things further there is a weak correlation between embryo grade and whether it is chromosomally normal or not.

And b) the results of a few IVF cycles are way too small a sample to tell us anything meaningful i.e. the results are not statistically significant. Until someone has undergone a low dose and high dose cycle a much higher number of times and then compared their results (obviously impossible) there is no way of knowing if the results from just a few cycles occurred by chance or are because of random fluctuations/variation. 
And for arguments sake, even if one person underwent a large number of cycles (i.e. the same experiment was repeated on the same person a number of times), there are so many factors involved with fertility that vary all the time and don't remain constant e.g. our hormone levels are changing all the time, our age is not static which means our egg quality is continually declining, our AFC is different each month and so on, and these varying factors may also skew the results. 

So you can see why it's very hard to do scientific studies (and get good evidence for anything) with IVF patients. Nevertheless studies are done where patients are compared with other patients and we do know some things, for example women who produce more eggs generally have higher success rates. So that's why it's important to try and maximise egg yield without compromising other things.

Anyway, sorry for the lecture - my point is that (without knowing more about your reserve and previous cycle) I wouldn't take it for granted that low dose stims are necessarily the best approach. The trick (and it's not necessarily easy) is to find that cut-off point where you are maximising your chances by producing as many eggs as possible but yet keeping your dose as low as possible (for reasons stated above).


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## Rosalind73 (Apr 25, 2012)

Hi Anna,

I'm not a doctor, but your blood test results seem okay to me:

FSH fine (ideally under 10)
TSH perfect (from memory I think between 1.0 and 2.0 is best for trying to conceive)
And your AMH whilst low is not terribly low (and remember only an indicator of the quantity of eggs you have remaining not the quality).

Just to give you an indication, my AFC ranges from about 5 to 10 follicles (depending on which clinic is counting!), and my AMH was 1.6 in Jan 13.
The first IVF I had was in July 2014 (so my AMH will probably have been lower by then) and I had 8 eggs. Then on subsequent IVFs in 2015 I produced 3 eggs, then 9 eggs and then 4 eggs.

I think doses of FSH vary from around 150IU to 600IU per day, so 300/375 is a medium dose. 
In terms of whether you can perhaps slow down your stimulation a little - can you remember how many follicles you had at your first scan and once you started stims? I remember one of my IVF cycles I had a few dominant follicles from very early on and because they were the only ones that really grew that cycle, I think it was a big factor in me being ready for egg collection in 10 days, whereas on my other cycles I stimulated for longer (12-13 days). So every month is different, which makes it very hard to predict what's going to happen if you cycle again.
What dose is your new clinic recommending? And what is their reasoning behind it? 

I don't really know much about natural modified cycles - what drugs and dosages are involved with that? But in my opinion, I don't think your ovarian reserve is low enough to warrant a 'mild' approach.

The other thing to bear in mind is that from what I read, it does seem to be the case that where a normal amount of stimulation is not producing many eggs, giving high drug doses may drive the ovaries to produce more eggs but this may not result in any more embryos. Possibly because it is allowing eggs to develop that your body would have naturally excluded i.e. by recruiting follicles with crap eggs in them. So that's another reason to rule out using higher doses in some women - however that's not the same as saying the high drug doses are causing the crap eggs/embryos. Again all we have at the moment is an association, and there's no evidence of causality i.e. that damage will be caused to a good egg (unless as mentioned before that perhaps stimulation has happened too quickly). 

Really sorry but I don't know what is meant by reduced vascularity - maybe someone else can help here?


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## janieliz (Jul 25, 2014)

Hi Anna8,

I am by no means medical in anyway, but I had a low AMH, well on paper it was 6.99, but in reality it equated to 3 follicles most times. I had an FSH of 11, as long as its under 10 I think you have a better chance of responding to meds. Higher doses don't necessarily mean not as good quality eggs, but as Rosalind says it could produce eggs that wouldn't have been selected. Can I ask what happened on your first cycle where you had 375 merional? The highest I had was a 350 cycle. Also, I think it depends if they do it in your natural cycle, I know the pill caused my dominant follicle, some people think its calms FSH but if you read Dr Sher's protocol about oestrogen priming for poor responders, it does not stop the dominant follicle situation. Unfortunately you won't know until you have tried, it's a case of seeing what works. You may respond really well to the higher drugs especially because your FSH seems to be ok. I went with the natural modified in the end because I did not respond to the higher dose of drugs at all and I never had that many follicles to begin with! However, I got lucky on my last one as I had 5 follies and started my low dose stims on day 3 and this helped all 5 of them develop. 

x


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## AmsterdamT (Jun 12, 2013)

I did a fresh cycle of ivf in Greece in Oct 2015 using 2 donors (long story). Transferred 4 (2 from each donor) and froze 3. Got pregnant with twins but had vanishing twin at about 8-9 weeks. Healthy baby boy born in June 2014. I'm now looking at trying again but don't really want multiples if possible. All 3 will have to be thawed at the same time (and re-frozen if that's what I want) but was advised to put back all 3 because of my age (41). I guess I'll do that but am a bit nervous of multiples and don't really like the idea of reduction. Would have happily had multiples for first pregnancy but less keen now - just because it will be harder to spend time with DS. But it was so hard to get pregnant the first time that I probably don't really have too much choice.


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## anna8 (May 10, 2015)

Thanks for the advice Rosalind. I'm glad my results aren't terrible but the doctors I've spoken to have all made me worry about my reduced ovarian reserve. i have no way of knowing the quality yet though, as I barely got any feedback about my frozen eggs-except to be told they were ok. 

When I had my egg freezing in July initially they counted 6 follicles but in the end they only managed to freeze 4 eggs, apparently something was wrong with the other two or they didn't develop.

Janieliz, I'm not really sure why they chose to give me the dose they did. I was quite new to the whole fertility treatment thing and I didn't really ask enough questions and did not know what questions to ask. Thanks for the feedback on the natural modified cycle as I might try that after my next cycle depending on the results.When I get my embryos frozen I will definitely ask about the quality and grade though.

I was on the pill (microgynon) to regulate my period and for a variety of other reasons prior to my egg collection and then switched to Yasmin, but my new clinic has requested I go off the pill. They seemed to be very against me being on the combined pill due to my age citing an increased risk of cancer and blood clots (which I knew about). They also said that pill can encourage peri-menopause in older women, which worried me. Its a shame as I really like the pill for its other benefits.

I was not able to do an embryo freezing cycle this month due to high estradiol and unruptured follicles and wondered if this might have anything to do with taking thepill.

My current clinic stating they wanted to increase the dose of my stims as I only produced 4 eggs before, but I hope that does not affect the quality. I can't really dictate to the clinic though. They do appear to have longer cycles than other clinics I have researched though. 

Anyway I have found your comments very useful and will do more research. 
AmsterdamT I'm glad to read about your success story but know what you mean about not really wanting twins. Of course having twins is better than not having children at all.


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## natclare (May 27, 2011)

Rosalind, really enjoyed catching up on your post as to be honest I never really understood why the Lister froze at day 1! The Lister will be my last port of call I think - even though I pay them 30 pounds a month for freezing. Think I'd prefer single FET of the blasts I froze separately to start with. Terrified of them splitting!! But as Anna says better two than none at all. Good luck Anna (and which clinic are you at now?).


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## anna8 (May 10, 2015)

Thanks Natclaire.  I'm going to a clinic in Bulgaria.


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## Rosalind73 (Apr 25, 2012)

Thanks NatClare. I don't think all clinics do a "freeze all" on day 1 (e.g. I think CRGH might freeze on day 3, which the Lister say is the worst time to do it). At the end of the day we have to rely on their expertise, but I did trust the Lister and they do seem to have a pretty advanced lab. 

Presumably it wasn't an option to freeze your day 1 embryos separately? 

The chances of them splitting is so tiny I don't think you should worry about it (isn't it roughly between 1 and 1.5% following IVF? About double what it is ordinarily, but still very low) - although I have to admit it did happen to me with one of my IVF cycles but sadly I went on to have a miscarriage.

Are you thinking about using your embryos now? Or is that still a few years away?


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## natclare (May 27, 2011)

Hi Rosalind, I actually don't know if the day 1 embryos from the Lister are frozen separately but I doubt it as presumably when they thaw only a few will develop from the five. The Lister are less of a worry to be honest as I'll use my Serum ones first I think (at least the three that are frozen separately). And you don't think that I should worry about splitting embryos? It is something that really worries me and is in the back of my mind but I guess if it happens, it happens. I am going for it September next year 2016, I think... eek. Still in last chance saloon of dating though so have a few last remaining vestiges of hope of doing this with a husband. Ever fading though!


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## Rosalind73 (Apr 25, 2012)

Yes as you say, it doesn't make sense to freeze them individually at day 1 as many won't be viable in the end anyway.

Wow that's exciting that you've set a date for next year! I really hope you do meet someone before then but I completely empathise with getting increasingly jaded about it...and at least you've got your baby options sorted. What you might call some very sensible family planning. I admire what you've done.


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## BroodyChick (Nov 30, 2009)

Hi Anna
I'm mum to a 17 month old boy who was a frozen embryo for 9 months following a fresh IVF which ended in miscarriage.
I was an egg sharer and got 12 mature eggs in total, 6 eggs for myself, 4 fertilised and 3 were frozen on day 5 (blasts). As I said i miscarried the embryo from the fresh cycle, took 6 months break and met a guy who was supportive of my plan to do FET three months after we met.
Turns out he had fertility problems!
I wouldn't freeze my eggs in the hope of getting some guy you haven't even met to contribute the sperm, I used a known donor and am OK with that but the quality from some twenty something donor might give you an even better chance. Like someone said before me, you want your own egg child and not worry too much about the kid being related to someone you're yet to meet. My ex was a dad already so you could end up getting together with someone who doesn't want more bio kids or can't have them.
Anyway I was single again when my baby was three months old, which was terrible, but at least nothing ties me to that loser now.
My little boy was embryo 3 out of 4 (number 2 didn't survive the thaw) and I've got one left in storage.
I'm 38 too and exhausted from being a single mum, so make sure you're close to a support network once you're pregnant.
Best of luck xx


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## BroodyChick (Nov 30, 2009)

I should add I got severe OHSS on the fresh cycle and did a drug free FET so yes it was much gentler on my bodyand led to a dream pregnancy!


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## anna8 (May 10, 2015)

Thanks for the additional replies, it really helps knowing that other people have had success following FET.

As previously mentioned, I only had 4 eggs frozen this July (2015) when I went to Cyprus, so I decided to go for embryo freezing instead. I was advised to take various supplements to help increase the number of eggs/improve the quality of my eggs. The supplements I have been taking are: DHEA, resveratrol,  myo inositol and melatonin. 

I am currently on day 6 of stims and I have been told it looks like I will only have two eggs suitable for collection as the other 2 follicles have not developed. I'm really upset and disappointed as the expected number of eggs for collection has halved since July and that's only 4 months later. The supplements don't seem to have helped at all, if anything I am worried that may have made things worse. Either that or my fertility has declined dramatically in just 4 months.


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## Rosalind73 (Apr 25, 2012)

Hi Anna,

It's early days still -  you may well have more follicles developing. I recall a cycle I had where it looked like I was heading for 3 eggs, then about a day before egg collection maybe 4 or 5, and then they collected 9 in the end. 

Having said that, I only had two blastocysts from that cycle - partly I think because a lot of my follicles grew rapidly and the eggs didn't have sufficient time to mature.  I also had the same number of blasts from cycles with far fewer eggs - 3 and 4 eggs respectively.

NB That doesn't mean that it's bad to have more eggs than usual, or to use higher doses of drugs, just that things vary every month and that for every given women they will probably produce roughly the same number of decent eggs/embryos no matter how many eggs are collected.

You're relatively young so, of the embryos you produce, a reasonable proportion of them should be chromosomally normal.

So what I'm trying to say in a roundabout way is try not to worry! Easier said than done I know.

Re the supplements, there is no real evidence at the moment that anything helps with improving egg quality. The biggest factor is age, and at 38 you're doing ok!


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## Altai (Aug 18, 2013)

Anna - don't be dishearted. Like Rosalind said - your age is your biggest advantage. 
What was your afc at the beginning of the cycle? Hopefully other follicles will catch up in time. 
Maybe you will do better with different protocol. I did letrozole only cycle and got 2 eggs.
Then tried tamixofen (clomid) +low doses of injectables. Tamixofen combo worked  the best for me. 
With protocols it all trial and error, unfortunately you have to try different ones to know which suits you the best. 
I'd also advise you to do banking with different clinics. Like some say - never  keep your eggs in the same basket. 

Good luck 

A.


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## anna8 (May 10, 2015)

Thanks for the reassurance Altai and Rosalind. My current cycle hasn't finished yet so I guess I don't know for sure there will only be 2 eggs. I will definitely discuss other options if I have another cycle, such as tamoxifen and/or clomid.


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## anna8 (May 10, 2015)

Just an update on my cycle. In the end only one egg was collected, I'm not sure why the clinic were unable to collect the other large egg but I will be asking. My one egg was successfully fertilised which I am grateful about and I was told that it is 15% fragmented. 

It appears that I am a poor responder to stimulation medications. The clinic have discussed the options of a natural modified cycle but I am waiting o hear more about the specifics as I have not had a chance to speak to the consultant yet. I have read the links about clomid and tamoxifen as being viable options for low responders but am worried about all the side effects, particularly of clomid. There's so much to read in the clomid thread so I'm feeling a little over whelmed. The main side effect I'm concerned about is thinning of the endometrial lining. Do you think I should rule out clomid for my next cycle? I'm not sure if my current clinic offers tamoxifen.


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