fertilization report...so upset!

[jkph]

I had my ER yesterday. Going in, I had 10 follicles. At my last ultrasound, I had several follicles well over 20mm, but they gave me stims an additional day after that anyways. At ER, they only got 6 eggs and of those only 4 fertilized. This was my 3rd round. I have never had a follicle not have an egg in it and my fert rate has never been so bad. Is there really any hope for these 4? I think they gave me too many stims and fried the eggs. Does anyone know what could have happened here? Are there other possiblities? Thanks for any help.

[phat95m3]

I wish we had 4....

we had 2 ripe ones, one was 20mm the other was 16mm on tuesday, with retrieval on thursday...guess what, by then, the 20mm was gone. so we only retrieved 1, which luckily fertilized and gave us a 3day 5 cell grade 3bc embryo.

it only takes 1, and i hope our 1 is the taker. so it could be worse for you...


after i found out the big one had released, i wanted to cry. but i just sat there in the waiting room with a big puss on my face instead....

[jkph]

Phat - You are right it does only take one. Unfortunately, it my case it is going to take a whole lot of them to get to the one that is good. During my 1st cycle, everything looked great, good eggs, 8 eggs fertilized but PGD revealed all of them to be abnormal. This time the embryologist only graded the few eggs they got to be fair. I guess my main concern is that this cycle was abnormal for me. If this is what had happened the other times then I wouldn't be as concerned. I guess you just know when something is wrong for you and your body. I am just trying to figure out the possibilites for what went wrong.

[SC-Impatient_in_VA]

jkph So does this mean you have 12 banked? And doing another cycle in July?

As to what happened, well, you probably ovulated off the biggest few follicles, or else the smallest few were empties. Empty follicle syndrome (you can google this for more information) is not uncommon in women who have a proven low yield issue (regardless of reason as far as I know). Some doctors think empty follicles are the fault of the meds, some think the empty follicles already ovulated (which is still a doctor issue) and some think that some women will just always have a certain chance at empty follicles.

6 mature with 4 fertilized is an excellent fertilization rate, when you can usually only have expected 3 to fertilize and possibly less at 36. I think this round actually didn't do half bad, despite the low yield. It IS about quality and not quantity since in the end you only need ONE healthy embryo, not 18 unhealthy ones.

I know it's disappointing but I think you're still in the game. Good luck!

[jkph]

Thanks Impatient. I was hoping you would chime in here. It seems possible that I ovulated off some of the eggs. I had at least 4 of them that were btw. 21 and 23 mm at the point where they gave me yet another day of stims. Unfortunately my RE was on vacation and couldn't make the decision about when I triggered. I thought it didn't seem like a good idea to let it go further but I am not a doctor so I just went with what they said.

They used ICSI to fertilize the eggs, so this fert rate is actually not very good. Last time all of them fertilized. Plus, the embrologist told me that they graded these eggs as fair. All of my other eggs have been rated as good (even though we know they probably weren't 'good'). So, it seems as though this round didn't produce a lot of quality either. I am mainly upset b/c I feel like my clinic messed up but of course they will not admit that anything might have been their fault.

I have 12 frozen now. I'm not sure about when to start the next cycle. My clinic would let me start as soon as AF comes but that doesn't seem like a good idea. I wish I could get a little more guidance from them. If I do end up having a baby, it will be in large part b/c of the info. I have gotten here!

[SC-Impatient_in_VA]

In theory letting you go another day should've been ok if you were on an antagonist cycle. My lead was at 23 when they had me stim one more day and THEN trigger and it worked out fine. Fertilization is usually around 75% even with ICSI (they average it at 80% but that's a little hard to do the math right offhand with so I go with 75%) and you're at 66% - it's a little low, but it's not horrible. My own fert rate with ICSI was similar -- 11 out of 15. (Just over 66%.)

I do also agree that taking a month off to have a natural period sounds like a good idea. It's what most clinics would do, to get the drugs out of your system and start fresh. Hopefully your next cycle will produce more and better eggs!

[KimAtFertilityAuthority]

I agree that you most likely ovulated the ripe ones before it was time I am so sorry about that, but it really only takes ONE! Good luck!

[cchopeful]

I'm sorry you're so disappointed, jkph! I had my ER on 5/16... they got 7 eggs, only 3 were mature, and only 2 of those fertilized normally. (And those 2 were only 4-cell at ET.) When I asked my RE why so few were mature, he said that they trigger based on the size of the follicles (I had a few over 20 on the morning of the trigger) and the bloodword results. He admitted that I probably should have stimmed one more day, but that sometimes they really don't know.... Your fert rate is really good, especially for 36. (I'm 36, too, so I'm in the same boat! ) I'm keeping my FX that your 4 embies are strong and healthy! Please keep us posted!

[WhitneyAtFertilityAuthority]

jkph and cchopefull: It's great that you guys are kind of synced up here and can offer insight for each other as you move forward. You are both 36, you both just had ER and some concerns with regards to your RE and overstim/understim questions. I am FX that your embies are dividing on schedule and that you will be moving towards FET soon. What are your plans there? JK are you going to see what thaws well and PGD before deciding to stim again? Warm thoughts to both of you.

[jkph]

CCHopeful - Congrats on your BFP! Looks like it worked out for you even if you did understim. That's great!

Whitney: I have one more round to do before PGD. It's too expensive to do PGD after each round, so I figured I would do a bunch and see if there is anything good in there.