# 2nd BFN. Poor embryo quality - what next?



## waffles (Jun 23, 2009)

Hello

Just had my 2nd ICSI BFN at the Lister. Have responded well to drugs both times and got 15 eggs (11 suitable) 1st time, then 20 eggs (13 suitable) 2nd time. Good fertilisation rate (7 out of 11, then 10 out of 13), but by the time we got to day 3, most of the embies had arrested. We were only left with 2 each time on transfer day. 8 out of 10 seems a high drop out rate. 

DH has a very low count (0.3 million) but has had the full range of genetic and chromosome tests, which all came back fine. My FSH, LH and AMH are all fine. 

What determines the quality of embryos? I imagine it is quality of eggs + quality of sperm? Is there a way of determining egg quality??

Does anyone have any advice on next steps? I have heard of immune testing, but think this looks at issues surrounding implantation, whereas our issue seems to be quality of embryos themselves. Maybe not?! (Please also let me know if there is a better place to post this)

We are having our follow up with the clinic next week and would like to go armed with questions.  

Thanks very much for any help!
Waffles xx


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## MsAsian (Aug 10, 2009)

Hello waffles,

I am sorry you had a negative cycle. I do not have any wisdom to share with you on this issue but just wanted to send you a BIG  
Lovely ladies on this site are so knowledgeable, I am sure you would get plenty of advise 

MsAsian


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## kitten77 (Nov 15, 2006)

hi waffles, sorry to hear about your bfn, just had my 5th bfn so know how your feeling.

not got much advice but we are going thro the same things, we are going for all the tests now as 5 txs is getting a bit much to keep going with no other tests, we are changing clinics to.

i believe we have implantation problems to, im a poor responder so not many eggs, but thankfully we have always got to ET (so grateful for that) but never never got to test date, always bleed before hand. 

will be keeping eye on this thread to answsers as would be good to see what people have to say. 

pm me if you need to chat.


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## peanut butter (Jul 23, 2008)

Hi Waffles and Kitten77

Really sorry to hear about what has happened to you both. Sending you both lots of  .

I thought I would join you as I have just had my second cycled cancelled before ET and have lots of questions about embyro quality that hopefully others will be able to give us some advice on.

On my first cycle, I managed to get 6 eggs and 4 embies.  2 resulted in an early mc and the other 2 had dividing problems when defrosted. This time I got 7 eggs, only 1 fertilised and this had dividing problems so ET cancelled.    My follow up isn't for a month so am interested in any questions/answers that you get from yours. 

Waffles - has your DH had any tests from fragmentation issues??  I have an FFer who knows quite a lot about it and I think it is a route that we will examine.  Happy to ask her to drop by and give us the benefit of her wisdom, if you are interested.

Trouble with this whole rollercoaster is that you never really know which way to turn next!!  At least we have each other to discuss it with.

Nx


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## scottie21 (Aug 11, 2008)

Hi Waffles

I too have poor quality embies but with no explanation.  Me and DH tests are all normal, I produce lots of eggs and the fertilisation rate is also v good however the quality of the embies is poor.  I think we seem to be in the minority unfortunately as most people seem to get a mixture of quality of embies so I'm sorry I don't have the answer for you.  So far I have drawn a blank as no-one seems to know why the quality is always poor (been the same for 4 cycles now).  I wish there was some way of getting answers.  The embryologist and the consultants are always left scratching their heads after seeing us!  I would be interested to hear of anyone who has a similar issue and what route they have taken.  

What did your consultant say?  I have tried to find out as much as I can but can't seem to get anywhere with it unfortunately.

Scottiexxx


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## waffles (Jun 23, 2009)

Hello ladies
Thanks for all your replies. Good to know there are some of you in the same boat. 

We had our follow up last week and no real explanation about poor embie quality - doc suggested we tried again, kept saying it is a 'numbers game' and we have 2 good embies every time which should give us a good chance. He didn't seem too concerned that we didn't get to blasts as apparently 1/3rd of ladies do not reach blasts.  We are going to look into more tests on DH sperm - DNA Fragmentation and Aneuploidy. Nothing to suggest any issues for me at the moment, but can have hysteroscopy and initial immune tests if I want (at the whopping cost of over 3k!!) Am feeling positive again, but hoping that is not naive. 

Scottie - what day do your embies start to suffer? for us, it is day 3 (good fertilisation and day 1/2), which is apparently when the 'sperm factor' starts to play a part. what tests have you had on DH sperm? 
Nikkipas - you were right re DNA Fragmentation - this is the next thing we should look into apparently. Would love any advice on this from your friend if she doesn't mind.
Hi Kitten and MsAsian and thanks for the hugs   

Waffles xxxx


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## scottie21 (Aug 11, 2008)

Hi Waffles

We have good fertilisation and then day 2/3 they start fragmenting.  They divide mainly ie reach 8 cells by Day 3 but the quality is always very low grade.  The last cycle the best was a 7/10 and the next best one was a 4/10.  So in effect they all seem to divide but fragmentation and size of cells etc is poor.  I only had 1 that was graded the best and that cycle I produced 18 eggs/16 fertilised.  Embryologist always says the eggs look normal too as far as they can tell.  DH sperm tests are ok but we haven't had the fragmentation test done.  We did donor Egg last year and the quality was better so thinking it's not a sperm problem?  Albeit there were no perfect embies with the donor but much improved on mine.  I did go on and miscarry though.  We never got to blast in any cycle as the embies were discarded as not able to be frozen and always replaced at day 3.

Nikkipas - would deffo be interested in your friend's experiences and wouldn't rule out a sperm issue at the moment.

Consultants don't seem to think there is a sperm issue but still can't figure it out


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