# Advice after 2nd failed ICSI with no blasts



## Katkin (Aug 15, 2019)

Looking for some advice and support please.
I’m 40, my other half 39. He has 2 kids from his first marriage. After just over 6 months trying to conceive naturally (regular periods, seemed to be ovulating regularly using OTC tests) we went to the Lister for some tests. My AFC was high (36) with a high AMH for my age (21). My other half’s sperm analysis was normal and they were pretty positive about our chances.  We were advised to do a short agonist antagonist protocol with freeze all due to risk of OHSS and to PGS.

Cycle 1-Aug- 225 menopur. 8 eggs retrieved, 7 mature, 4 fertilised and still going at day 3, 2 blasts on day 5. Both abnormal on PGS. In the end used ICSI as partners sperm count slightly low (12 million) but normal morphology, motility.

Advised likely just unlucky and to repeat with higher stim doses as I hadn’t been as sensitive to stims as they’d thought.

Cycle 2-Oct-300 menopur. More follicles at baseline. 16 eggs collected, 15 mature. 10 fertilised (ICSI again), 8 good embryos on day 3.on day 5 advised that only 2 very early blasts and 1 morula which were not looking good.  They gave them an extra 24 hours but none progressed so advised nothing good enough to biopsy or freeze. 

So 2 cycles, 24 eggs, no normal blasts and no transfer.

My question is do I keep going with OE’s and hope that eventually a good egg comes along or should I accept that given I’ve had 24 eggs and not a single normal blast at day 5, that the likelihood of ever conceiving with my own eggs is v small?

I have found the whole process completely emotionally crushing, particularly this most recent cycle which was looking so much more promising in terms of egg numbers, but clearly not egg quality which seems to be the main problem.

I don’t know how I feel about donor eggs, I think I’m not ready to accept that yet. On the other hand, I think ploughing into another cycle like this most recent one would be very hard to emotionally deal with if the same outcome. 

I don’t smoke, am a healthy BMI, eat fairly healthily. I don’t drink a huge amount normally and had stopped over the cycles but not for months before. 

I guess looking for some advice as to whether to try and pick myself up and try again (when I’m feeling a bit stronger) and just hope that it might be better next time  or if I need to start facing facts that I might have ok numbers but the egg quality is just not there.

This stuff really is hard isn’t it?

K x


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## cosmopolitan4112008 (Oct 18, 2013)

It is very difficult to judge why those blastocysts were always abnormal. If could be the age, it could be a dose of medications that you were given because the higher the dose, the more damaging to the eggs it is. Those medications burn the eggs and the point is to get quality over quantity. Maybe to suggest them to give you dosages that are 150, not more. In the meantime, take ubiquinol 300 daily for at least a month, ideally 3 months. Apparently it helps with the egg quality. 
Good luck!


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## Tigs33 (Jan 31, 2014)

Sorry to hear about your outcome.  I think trying again, depends upon if you can afford to and if you would eventually want to go onto donor eggs.  I tried three IVF rounds using my own eggs, (unsuccessful) and then tried donor eggs and we were successful with our second donor.  Currently BFP again with a leftover frozen embryo.  If you do want to go down the donor route then you have plenty of time for this and it is more successful than using your own eggs.  Perhaps see what the clinic advise as your next move.


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## Guest (Nov 3, 2019)

With the amount of eggs you are getting it is a numbers game and if I were you i would try again definitely. You could always try the low Stim protocol which is lethrozole for 5 days and 150-225 of menopur from Day 2 or even go on a higher dose of 450 and see if you can get more eggs, speak to your clinic they will advise you based on your numbers. If money is an issue then I think after the next round if that fails you may need to stop and consider DE if you can do that. 
For me I have done almost 13 rounds from 41-44 and no look, doing my final round now. Unlike you I got only 2ggs each time but they would nearly always get to blast but no look. I don’t regret doing the rounds as there was always some hope but now at 44 it is a struggle to get one follicle to grow! So age makes a huge difference so whatever you decide better do it sooner rather than later that would be my advice.


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## missl73 (Mar 12, 2018)

Has your partner’s sperm been tested for DNA fragmentation? Even men with normal semen samples can have high fragmentation which can cause embryos to arrest before day 5. It’s called the late paternal affect, if embryos are good quality at day 3 and start to fail between days 3-5 this can indicate a sperm not an egg issue.


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## Loopie Lou (Apr 4, 2018)

You're right it is so hard, emotionally and physically.
Your first round with lower stimulation and fewer eggs would surely get better quality eggs. As said already its quality not quantity, plus you will save money on the drugs! 
Make sure you've explored all possible reasons for infertility before going into your next round, like DNA fragmentation and from your side. Don't just assume your clinic has done everything they need to. Some just jump straight to IVF before all the information is there that can be gained and improvements can be make to either side.
It's not uncommon for your body to just have a bad month, just like your partner seems to have had with lower sperm numbers.Unfortunately it just ends up a very costly month. It's a shame icsi had to be done just based on that. Is that the norm for that set of circumstances? 
Best of luck going forward x


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## Katkin (Aug 15, 2019)

Thank you so much everyone for the replies and advice- I really do appreciate it. 

We have our follow up appointment on Wednesday so I’m hoping that might shed some light on what they think are the issues. I think we will cycle again once I’m feeling a bit stronger but I’d like to feel we’ve done all we can to understand and  optimise the situation first.

Cosmopolitan-I’m going to get started on the Ubiquinol -thanks for the suggestion.

Tiggs-thanks we’ve managed to get an appointment on Wednesday to go through this cycle and formulate a plan going forward which I hope will help psychologically 

Cath A- best of luck with this cycle and utmost respect to you for having the strength to persevere.  I really hope this one is the lucky one for you-will keep my fingers crossed for you. 

Miss173- thanks for the tip. I’ll ask about them about DNA fragmentation testing. 

LoopyLou-I quite agree, I know there aren’t always answers but I don’t just want to plough back in and have a repetition of this cycle  (although I know it’s all so unpredictable). I did question whether if his sperm count had recovered we could give ivf a whirl but their advice was that you wouldn’t want to risk it in case no/low fertilisation and better to err on side of safety and use ICSI. I don’t actually know what his sperm sample analysis looked like this time round...another of the questions to ask on Wed! 

Thanks again everyone for taking the time to reply. I feel really comforted by the advice and your support. 

Xx


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