# Third failed ICSI - what now?



## marwil (Jan 13, 2011)

Hi all,

We have just had our third failed ICSI treatment for a sibling. 1st - 3eggs - 2 embryos put back - BFN, 2nd only one mature egg - no fertilisation! and just now 3rd (different protocol) 7 embryos - 2 put back, nothing to the freezer though - BFN. It took us 5 rounds to have our daughter who's 2yrs old now. I'm afraid it might be to late now as I'm 39 this year. 

Anyone with similar story maybe? I'm just torn on what to do from here...


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## Anuh (Jul 2, 2015)

Hi marwill

Sounds like you need Dr Gorgy
http://www.fertility-academy.co.uk/recurrent-failure/

This clinic is different to all other clinics where they actually investigate why the previous lead to miscarriage or failed rectify and start new cycle.

Even after a positive unlike most clinic which let you move to nhs after 6 weeks they will monitor you as long as needed.

A friend of mine managed to get pregnant after five mc's and now she is 28 weeks she is still being closely monitored by them, and every four weeks she still receives intralipids. Upto 20 weeks she received ivig and she believes this is the reason she managed to keep this baby.

They offer a more personal service as we all are individuals isnt and one size does not fit all.. Or usually most places long protocol short protocol.

Theres a forum on ff if you want to ask other ladies who is using this clinic

http://www.fertilityfriends.co.uk/forum/index.php?topic=342841.0

Best if luck. X

A bit about me 4 x failed cycles met dr gotgy got first positve ever.. Unfortunately miscarried 14.5 weeks december... And decided to take a break before trying and due to immune meds still in my system managed to naturally fall pregnant... 15 years no protection sex and this is defo something to do with dr gorgy. He stocked me with all meds needed and monitoring the pregnancy as i have a very complex immune..

/links


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## marwil (Jan 13, 2011)

Hi Anuh and thanks for your reply. 

I should mention that I have been pregnant twice, on my 2nd IVF (before my daughter who's conceived on the 5th round) but sadly lost the baby due to abnormalities, not genetically though. 

So with that, I'm just thinking if it's worth going through another cycle because that might be our lucky one again. Or are my eggs too old by now... I also have low ovarian reserve and the quality is not great. 

Anyway, thanks for the link and mention of this Dr, I had a quick look just now but will read more about the clinic. 

Huge congrats on your pregnancy, what a lovely surprise you got!

Take care,


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## Bluebell82 (Jan 24, 2015)

Hi Marwil,

I've not been exactly in your shoes, but I do think that egg quality is an important factor in IVF success. It is influenced by (1) your natural propensity to produce more or fewer good eggs, (2) the stimulation protocol, and as you suspect, (3) age (which affects chromosomal normality and number of eggs retrieved). 
When I changed clinics to ARGC for our third IVF, their tailored stimulation definitely helped improve my egg and hence our embryo quality. In my first (100% own egg) cycle I only produced 1 early blast (which probably became a day 6 blast but they put it balc beforehand) from 12 eggs, while this time we managed to get 4 good quality day 6 blasts from 15 eggs. ARGC also managed to get the transferred blasotcysts to implant, so competent embryos met receptive womb lining (the latter seems to have played a major role in my unexplained (immunlogical?) infertility, but not everyone suffers from implantation failure). 
You only get successful implantation if you have both, good embryo and receptive womb. As you have many cycles that result in BFN, it means that on many occasions one or the other isn't quite right.

I think your hunch is right that eggs contribute to reduced success at 39. Just look at how HFEA success rates drop when women's' age goes past 34 (for any fertility clinic really). You will be producing fewer competent eggs now than a few years ago. The fairly low numbers of eggs harvested from you doesn't help to deal with that. My feeling from observation on this forum is that ladies around 40 who get many eggs have the best chances of achieving pregnancy at that age.
If you wanted you could try ARGC, but they are based in central London and treatment is expensive no doubt (we've spent £20k on this cycle, which includes intense early pregnancy monitoring and a slate of pregnancy supporting medications). ARGC struggle with age related decline of egg quality to the same degree as other clinics, but they do get the best out of your eggs and your body. My impression is that the younger you are when you use them the better their ability to fix you up. For example, they aren't more successful at getting 44 year olds pregnant than the average UK fertility clinic, but their success rate for <35 year olds is pretty much double the national average.

I guess it all depends on your remaining energy and financial situation, what path you go down. Immune treatment helps with implantation, tailored stimulation improves odds to get a normal egg, but they don't fix age related decline in competent eggs or decline in egg reserve/response to stimulation. It may be helpful if you try to get your doctor to give you a personalised estimate (ideally a number or range of numbers) of your chances of success (e.i. your age and your number of eggs and previous fertility history) to help you with the decision what is next.

Hope this helps.


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## marwil (Jan 13, 2011)

Hi Bluebell,

Thank you for your thoughtful answer. And congrats on your pregnancy! that's fantastic news  

Yes I have a hunch that it is a matter of egg quality, or embryo quality really, as we need ICSI because of male factor that started our journey through treatments. From the beginning I have had low response and I believe there's a connection with that and quality. 

I have a follow up phone call with our doctor tomorrow and I will ask his honest opinion on these things and our situation in particular. I hope that conversation will give me more information on what our next step is, if any.

Best of luck,
M


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