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Thoughts on 4th IVF Protocol

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  1. #1
    HopefulHusband
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    Thoughts on 4th IVF Protocol

    My wife and I are about to begin our 4th round of IVF, and I would like to hear some opinions regarding our protocol and if anyone else has had a similar experience (along with final outcome). My wife has PCOS and our issue is egg quality, per 3 different doctors.

    We began with 3 failed IUI's which came and went quickly.

    1st round of IVF (Antagonist Protocol with HCG trigger):
    Understimulated - 17-day stim cycle (Dr was cautious with low dose of meds because of PCOS)
    Only 5 mature eggs, all arrested by Day 3

    2nd round of IVF with ICSI (Antagonist Protocol with HCG trigger):
    Overstimulated (Dr doubled the dose because of previous understimulation)
    25+ eggs from only one ovary (the other ovary was too swollen to get to)
    18 mature, 15 fertilized, ended up with 3 embryos to freeze at Day 7 (growth was very slow)
    Embryos were poor quality, but had first transfer anyway with 2 embryos - they did not implant

    3rd round of IVF with ICSI (Long Lupron Protocol with HCG trigger):
    Switched doctors and Long Lupron was suggested to try and suppress my wife's ovaries to the point of getting better eggs, along with retrieving one day early to help avoid overstimulation
    17 eggs were retrieved in total, 14 mature, 12 fertilized
    At Day 3, nurse called and said there were 5 embryos left that looked "stellar"
    We went in for a Day 5 transfer and were told all arrested

    About to begin 4th round of IVF with ICSI (Long Lupron Protocol with HCG trigger):
    Our doctor believes we had the right protocol, but that there are a few improvements we should make for this round.
    1) My wife was on BCP for 6 months to really suppress her ovaries
    2) Our retrieval will be on the day it should be, rather than one day early like the previous round. Dr believes some of the eggs may not have been ready to come out and the extra day can further their development
    3) Instead of disturbing the eggs and checking them on Day 3, they will remain in the lab unharmed and only be checked on Day 5 transfer.

    Thanks.


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  3. #2
    Patient-One
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    Best of luck to you both. You are in my prayers.


  4. #3
    Hopingforlilone
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    Have you had a sperm analysis? Did they use icsi for the cycle with the stellar embryos on day 3 which arrested by day 5? I have read that embryo growth or lack of is dependent on egg quality for first 3 days and then sperm quality to get to blast. Not sure if this is true though, but it's another avenue to explore. Also are you and your wife tasking any supplements? We took CoQ10, Maca, Vitamin D prior to egg retrievals, and I feel like they helped. Also took HGH, it was expensive, in the end not sure what did the trick
    IVF #1-3: July '12 Cx, Oct '12 & Aug '13 BFN
    FET #1-2: Nov '13 June '14 Cancelled
    FET #3: Jan 2015 BFN
    Changed RE, banking for PGS
    IVF #4 & 5: Nov '15 & Jan '16: 1 blast - abnormal
    IVF #6: Mar '16: 3 to blast - 2 PGS NORMAL!!
    Mock cycles for ERA May & July '16
    FET #4/#5: Sep '16 Nov '16 both cancelled
    FET #6: Feb 7, 2017 Our dream finally came true Oct 2017 we are a family of 3!


  5. #4
    Patient-One
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    Some RE believes that the best place for the embryo is in the body, so have they ever mentioned don't a 3 day transfer rather than a 5 day. Even though they don't make it to blast that doesn't prevent them from implanting at a 3 day transfer.


  6. #5
    HopefulHusband
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    Thank you all for the advice. Our clinic did recently become 5-day transfer only, but our doctor said he will review our eggs following fertilization and exceptions can be made for day 3 if he thinks we would have a better shot. Currently using COQ-10 and Vitamin D. ICSI was used except for first round. Sperm analysis came back normal.


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