Poor quality embryos *TW*

[talon]

Hi, I'm talon. I posted in 3T and IF at the other sites. I'm not really TTC any more but I would like to if I knew where to start. Sorry this will be long.

My dx are PCOS (but I ovulate on my own), hypothyroidism, and MTHFR. DH has low morph and motility but our biggest issue is 99% of his sperm have antisperm antibodies attached to them. It's pretty rare. I'm 36, DH 46.

We did a few TI cycles and 1 IUI before figuring it out so then moved on to IVF w/ ICSI.

*TW child mentioned*


Our first IVF cycle we had 8 embryos that looked great the first few days. E2 was super high, like 4,000. By day 5 all had died except 2 that were crappy quality (still morulas with some defragmentation). We transferred those 2 and by some miracle got pregnant with my DD who is now 3 1/2.

We tried again last year and got 19 embryos this time, though weirdly my E2 was a lot lower like 1200 I think. Again they all started out strong but by day 5 all but 2 had died and they were lower quality again. Transferred 2 which ended in a CP.

My RE kinda sucks and views our "stats" as 50% of my cycles were successful, thinks we should try IVF again with no more answers. My thoughts are that 26 dead embryos and 1 kid is a pretty crappy record and we just got lucky. We did do the basic karotyping which came back normal but no further testing.

Does anyone have thoughts on where to start? I just feel like I need answers and there has to be a cause for so many of our embryos to have died. Thanks for reading

[moto]

**grad warning** I hope you don't mind me jumping in here.


Hello! I'm sorry you've had so much trouble. With your history, it seems like it couldn't hurt to talk to another RE for a second opinion. I think you're right that your embryo survival rate is lower than average and maybe a different RE would have some ideas on how to improve it.

Other ideas... would your RE be willing to transfer on day 3 vs day 5? I've seen stories on here where some embryos do better in the uterus than they do in the lab. My RE would only do 5-day transfers so maybe this approach is not backed by recent science, but still worth asking about.

Have you ever read "It starts with the egg"? I read that book when I was going through IVF the first time and I made a lot of changes based on it. It's a well-written book that gave me hope maybe I could improve the quality of my embryos. The book recommends changes in two main two categories: 1) a variety of vitamins/supplements, all with explanations of why they might help and studies to back this up and 2) many environmental chemicals to try to avoid. For me this mainly meant finding different cosmetics and trying really hard to avoid plastics. I'm not sure if those changes helped, but I think they did... and plus it made me feel like I was doing all that I could. IVF made me feel so helpless, so doing something made me feel better.

I don't have any advice about your specific diagnosis, so hopefully others can weigh in about that. Good luck!

[bonzo]

I don't have advice specific to your diagnoses, but I agree that you should seek the opinion of another RE. That's a huge attrition rate, and another RE may have ideas about how to increase the quality of the embryos.

[hoosiermama76]

I don’t have any specific advice that hasn’t been mentioned, but as a nearly 42 year old, I worry about the same thing. I just talked to my doc last week about improving egg quality and he mentioned coq10 being the only one with science behind its claim. I’m trying it.

[jense927]

I also don’t have much in the way of advice but will be following this thread. We have had 3 fresh cycles. One with 8 embryos of which we got two decent quality blasts. One with another 8 embryos and a 3AA blast. And other with 4 embryos and only one that made it to morula. That was my one pregnancy from this process and it ended in a loss.

I am also taking a coq10 supplement. I started about 2 months ago so I am hoping we see some improvement with our next fresh cycle. The RE I am seeing didn’t seem to have many ideas other than the supplement to improve the quality. She is of the mindset similar to yours. The more attempts that you give it the higher chance of success.

[talon]

Thanks for the ideas. I do need to suck it up and find a new RE. I actually had a consult with the only other office in town before either of my IVF cycles and wasn't too impressed but there are a few doctors there and hopefully they'd at least try to figure out what's going on. And I did take CoQ10 before my last cycle but only for a month and I think it takes longer to help.

Does anyone even know if it's more likely to be a sperm or egg issue with the sudden decline? They seem to do great until day 4 or 5 and then suddenly stop growing.

[bonzo]

From what my RE has said, if there's an issue before Day 3, it's typically an egg issue, and if it's Day 4 or after it's typically the sperm. Of course that's just the trend, it's not always the case. You said your H has MFI, is he taking any male fertility vitamins?

Also, for both eggs and sperm, it takes at least 3 months for supplements to really affect quality. So definitely start CoQ10 or any other supplements at least 3 months before a retrieval.

[sally]

Welcome/welcome back! I remember you from the last place. It looks like you're leaning that way anyway, but I'd get a second opinion as well.

I've also heard the "it takes 3 months" for supplements spiel, so that might also be something to consider. Good luck!