# End of the line or carry on? CF carrier Azoospermia & Poor Responder / low AMH



## Snoopie (Oct 22, 2014)

In the space of 12 months my hubs & I have gone through 4 rounds of IVF/ICSI and despite doing all we can (sperm retrieval to get swimmers out) plus me pumping myself full of DHEA to improve our egg quality we've only had 2 chemical preggies.

I feel emotionally, physically and financially wreaked by the whole process. We manged to get an improvement in egg quality: 5 eggs retrieved originally with a couple of 7cell grade 1&2 when we started. Post DHEA consistently getting a couple of 8 cell grade 1&2s, plus and some 6 cell embies. We managed to make it to slow day 6 blasts in our last two rounds, but the best embie was still only a slow 4BC.

Hubs is convinced it's him, as were getting a massive variation in fertilization rate (60%,45%,85%) depending on the sperm they manage to get. We make good progress to day 3 but then things slow down. They also keep telling us it's difficult finding good motile sperm and only managed to get grade 1 sperm because they used an IMSI microscope. We got a chemical BFP then a crushing BFN two days later.

The DHEA has definitely made a difference, my AMH was 3.7 15 mths ago, it's been 9.37 a few months before our bumper 17 egg cycle, but has since dropped to 4.3. Most of our cycles have been 5-8 eggs collected and I think my egglets are running out of steam. I'm turning 41 in Feb, and surrounded by female family & friends having kids left right & centre - I'm happy for them, but it's a reminder of how far we are from getting anywhere close.

Hubs thinks we shouldn't keep dashing our hopes, he thinks I may have a better chance with a younger donor, equally I think a younger egg might better support any weakness on his side. We're both near the limits of what our bodies will do. I prayed for baby snoopie to please stay.... But it couldn't. I feel heartbroken that that was the closest I will get to being a mother.

It's so tempting to ignore the chances and keep hoping... But I /we can't take any more heartbreak

My question is, has anyone how's over 40 with low AMH, whose partner is a CF Carrier, Obstructive Azoospermia had better luck?

Good luck to the mummies & daddies in waiting


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## WayneE (May 9, 2014)

I'm sending you hugs Snoopie. It's so hard to know what to do for the best.  You've really been through the ringer. Four rounds of IVF in one year is tough going, I've had three unsussessful rounds this year. To be honest your eggs seem really good to me; from what I've read it's the quality that's important. 

I'm glad DHEA has made a difference for you. I started taking it in June, however, I just had a 'no response' to max dose menopur last week so my IVF was cancelled. I think my ovaries were over suppressed as this was the first time I was put on the BCP. Mind you, last two IVF tries I only got 2 and then 3 eggs in total.  My consultant has put it down to my age, I'm 42, and he's given up so I'm changing clinic. I get my bloods done tomorrow with the new clinic so that will give me a starting point again. Or they might show me the door too! I keep telling myself it only takes one good egg and a little luck.

I'm also really fed up with all and sundry around me getting pregnant or making comments about life without kids and what's the point of it.  If I hear once more comments like, "as a parent," or, "you're full of big ideas til you've had kids," I think I'll squeal. 

My DH doesn't have specific sperm issues but does have chronic illnesses so that may be affecting our progress but it's all so unknown.

Chin up Snoopie, whatever you decide to do. You can only do what's right for you and your DH.


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## Snoopie (Oct 22, 2014)

Hi WayneE,

Thank you so much for replying, sorry I didn't spot your reply sooner. I didn't have the alert set up and at the time of posting I just slumped into a really hopeless place.

Since then my hubs and I decided to go down the donor sperm route to see if it is an egg or sperm issue. We're just in the middle of stims for what will be our 5th cycle.

Taking a break from everything helped, and coming back to it the process has been daunting, but reading your message that you posted really made a difference. It's  funny, we all know we're, not alone, but IVF can make you a stranger to yourself. So thank you for reaching out.

I'm sorry to hear that you've had trouble with your cycles, the cycle cancellation must have been tough. How long have you been taking the DHEA, I found that I needed a good 10 weeks for it to help, and there is a 3mth lag. So you need to take it for a good few months before you cycle.

Changing clinics also helps psychologically, sometimes you just need to mentally and physically start afresh. I hope you've found somewhere supportive and big hugs and good energy back to you. I hope 2015 brings you magic


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## Cordelia (Mar 7, 2005)

Hi snoopie. We are in a very similar position.  I have low amh and only got 3 eggs last cycle and we generally only get 1 that is any good.  I'll be 39 in June.  Hubby is cf carrier and has obstructive azoospermia, has had MESA and PESA previously but has 56% sperm dna frag.  We have had 4 rounds with one chemical.  Last round did donor egg to give us a better chance and it was a disaster due to the sperm.  Embryos started dying off after day 3.  We have since seen a urologist and hubby is on a sperm improvement protocol for 3 months before we do another donor egg cycle in Greece at the end of March.

It is so hard, we really didn't expect ivf to work first time but didn't expect to be using donors either.  If this doesn't give us better sperm results then we may have to consider double donation and OH is struggling with the idea of donor sperm.  At this point whilst egg donation was not our first choice I just want to be a mother and to move on from the devastating and all consuming world of infertility.

I hope your cycle goes well this time and you get your bfp.

Cordelia xxx


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## Snoopie (Oct 22, 2014)

Hi Cordelia, 

It's a weird comfort to know someone's in the same boat, so my heart goes out to you. You're also probably also tired of hearing 'it could still happen naturally" nope not with Azoo it won't. :-(

I think sperm health boost could help and seems like a good plan. That's not a possibility for us due to complications of the surgery last time, OH can't have it done again. But trying to get quality up is a good thing so good luck!

I like you, I  just want to have a family, the donor step isn't easy, but the way we've approached it is to try for two children: One with my eggs / donor sperm the next time with with donor eggs / OH sperm. 

That way we've maximised our chances and given both of us a chance to biologically be part of our children. It also means, we both have to accept the donor option rather than one of us to miss out. 

As OH sperm is on ice and my biological clock is near the end we're going for donor sperm first (by the way there are studies that suggest younger sperm older eggs have higher preg than older sperm- so there is a male clock too). If we get lucky we could end up with two little ones, but hopefully at least one - either way we'll leave the universe to decide which combo has the best chance - makes it feel fairer, but also a little more 'meant to be' rather than mechanical - or that's just me maybe.

The reason I say that is that you're not yet 40, your eggs still have a good chance. I know donor sperm with your eggs, might not be easy for OH, but it's no easier for you dealing with a donor egg option. 

I hear what you're saying about low egg count/ AMH. My AMH was 3.7 pmol a couple of years ago, I'm one of those ppl who's really seen a difference with DHEA, my AMH has varied a lot on it, but I'm between 4.3 and 9.37 (I stopped testing it) given that I'm older it should have gone down to 3 not up to over 4.3. More importantly my egg count went up from barely 5 to reguarly over 8 and even up to 17 in one cycle.

None of this is easy, but you both deserve to see if the donor option could work for either of you. It takes 3 months for the DHEA to have an effect, do it at the same time as the sperm health plan and see if your AMH or Antral follical count changes maybe. You've got nothing to lose...

Just a thought, either way lots of hugs and baby energy to you


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