Help please: bad 2nd fresh cycle


#1

Hello all –

Here I am having just gone thru my 2nd fresh IVF cycle which was an abyssmal failure. Unfortunately none of my embryos made it to blast this time, but it was really a night and day difference from my last experience! Here are the differences in the two cycles:

October 2012 – 23 eggs retrieved, 13 fertilized
13 made it to day 5; transfered 2 and froze 4 (this cycle resulted in miscarriage)
Antagonist protocol was 225 follistim, 150 menapur, ganirelix. Stimmed 9 days before trigger.

NEW CLINIC
August 2013 – 12 eggs retrieved, only 3 fertilized, lots of immature follicles.
NONE made it to blast, so nothing to PGD.
Antagonist Protocol was 225 follistim, 75 menapur, but went up to 300 follistim and 150 menapur on day 5. Ganirelix.
Stimmed 8 days before trigger. (New RE prefers to trigger early to avoid hyper stim)

So – this last cycle was a complete failure. Why?? There was not that much of a difference in the protocol, and it’s not even a year later. I just turned 40 the day before my retrieval, but I always have tons of follicles and my FSH has never been above 6. Any ideas what is going on???

I am planning to cycle with this doc again; he is discounting the next cycle and I think he’s quite disappointed, as am I. Has anyone else experienced success after something like this, and is there anything I can do to get a better result on the next round?

Any input from you ladies is appreciated. I’m getting close to tearing my hair out! :grr:


#2

My dr told me that response might vary from month to month. In November, I had 26 eggs but only 4 blasts out of which 2 cgh normal. Then April, 20 eggs, 12 blasts but 2 normal. June cycle gave me only 8 eggs but 5 blasts, none cgh normal. In all these cycles, I used bc and 150 menopur. So, for the next cycle, I won’t be usi g bc and only 75 menopur, in addition to 150 gonal f. Try to take less menour because sometimes it damages eggs. Also, if possible, have your blasts tested on day 5.


#3

I think its the early trigger myself 8 days isnt mong enough yo mature a whole lot of eggs. If he really wants to prevent ohss trigger with lupron. Theres no chance with a lupron trigger. Ive had ungodly amounts of eggs andhigh e2 and have avoided ohss. I know u want to stay with your dr but dont be afraid to question something thay didnt work for u


#4

It sounds like your new RE triggered you too early, which is evident by having a lot of immature follicles. Have you checked the SART scores of your old clinic verses your new clinic? The quality of the laboratory is immensely important. No matter how great a RE is, if the lab is not, it’s a waste. I’d go back go the drawing board all together & find the most successful clinic for your age group, that’s an option for you. If you leads you back to your current RE, have a thorough discussion about when you will trigger.


#5

I just wanted to share my experience. I was your age when I went through 3 cycles (turned 40 a day before my first egg retrieval).

My first cycle, (Antagonist cycle) after 9 days of Folistim 225 and Menopur 150, most of my eggs were immature and unable to be fertilized. I was devastated. Second cycle we used HGH and went a day longer on same doses of meds. We got 16 eggs but still many immature eggs…

I searched on this forum and other sites for answers, and tried supplements, changing diet and acupuncture.

On my third try my RE changed the protocol to Long Lupron and changed a med from Follistim to Gonal F. We still used the HGH (ominitrope) and ended up with 14 eggs, 11 of them fertilized. 4 made to blasts, and two took.

I understand how you feel because I was there. I was looking for answers but I couldn’t get from anyone (RE was expecting better responses on first two and could not give me answers). But I tried whatever I think it would improve the odds for success.
I also want to add that with our age, in order to have a success it might take a few tries and changing more than one factors to improve outcome. There are so much info on this board and so many of us who are supportive to each other. You seem to have good AFC count and good number of eggs at retrieval.

Best of luck to you and lots of baby dust:babydust:


#6

Thank you all very much for the responses!

CaliNurse – your experience sounds the most like mine; I think the doctor may try a different protocol in 2 months time. My doc also had no answers, just said it really can vary from cycle to cycle. Assume you are in CA by your name; I actually am too. My first IVF and 3 FETs were with Kaiser in Fremont and this last cycle at HRC Pasadena. Any recommendations there?

luv4rachela – Actually the reason I chose HRC Pasadena was because their SART success rates (live births per transfer) for my age group are number 2 in CA for 2011, and I think number 5 in the whole country. And I have family in that area, so I thought it was a no-brainer. Maybe not!! I did go thru one IVF last Sept and 2 FETs back to back (and that was TWO miscarriages and a chemical preg in May), so maybe my hormones are just screwed up because my body has never been able to fall back into its natural balance?? Not to mention my dad passed away two weeks before this cycle so I may have been more stressed than normal.

cosmopolitan4112008 – The plan was to test at day 5 but I had nothing to test by then. :frowning: sadness

I was actually quite worried about the doc triggering after only 8 days as I knew I had a lot of immature follicles, but I think part of what happened is that one follicle jumped ahead of the others and he didn’t want to let it go too far; but I do think I should have gone an extra day for sure. In the end out of only 12 eggs, 5 were mature and only 3 fertilized. Terrible!!

Again, less than a year ago my FSH was only 5.8. I am thinking maybe of going back to acupuncture, which I stopped for awhile, and I should lose weight too (around 30 lbs). No one has ever really mentioned PCOS to me, but my fasting glucose level is a little high and I wonder if insulin resistance may be an issue. None of the docs have ever said so but I am willing to look at anything.

I’m just not sure how people are able to remain positive thru all this! It seems like if it’s not one thing, it’s just another… anyway, done ranting now, thank you!! Any experiences anyone can share are so welcome!


#7

If you had many chemicals, I would also recommend hla matches testing (just to make sure before you go into another cycle). Pgd for sure once you have blasts. Finally, if it happens again that you have immature follicles, is IVM available at your clinic (the lab puts those follicles into special incubator till they become mature)?

It is difficult to stay sane and optimistic, but it is either to continue or give up. Hopefully, all of us will have babies sooner or later because God knows we wouldn’t be suffering this much if we were not willing to be good parents. I’m optimistic:)


#8

Hi there,

Yes I spent most time in So Cal. I heard about Kaiser Fremont and HRC Pasadena, but I cycled with Dr. B at FSAC in Thousand Oaks due to a recommendation. I responded well to meds (9 days on first and 10 days on second cycle), good follicle sizes and E2 level > 4000 before triggers each time. But we were disappointed with so many immature eggs. My RE said my response was “atypical” and didn’t have an explanation like I said before. I searched on internet and there were very limited information about most immature eggs at retrieval. I read about IVM, but these eggs matured later typically didn’t do well. I am not sure it is because of lack of lab technology or egg quality itself.

I looked into a lot of things and asked questions to my RE after each cycles and he was great answering questions and suggested tweaking protocols here and there. I mentioned about Insulin resistance but he said I did not meet the criteria. But that would be a great question for you to ask your RE.

I don’t know what made me to have better response with my third cycle, but I started acupuncture twice a week 2 months prior. You responded well with your first cycle last year. Were you doing acupuncture? I went religiously and I thought it helped to reduce stress at work and perhaps improved the blood flow to my ovaries… I also did before and after FET. So I recommend reducing stress (I am so sorry about your dad) and acupuncture.

I was originally planning to do PGD but I opted out at the last minute, since I read some posts about normal PGD or CGH embryo transfers coming out with BFNs, suggesting mitochondrial insufficiency. But with your history PGD is a good idea. So I would inquire your RE about that as well (most likely he might offer no explanation) and do your research… Always good to be your own advocate.

Good luck and let me know if you have more questions!!