FAILED first cycle with HRC, need advise before cycle 2 PLEASE!!

[babyprince]

Hi Ladies,

I would appreciate your help. Is there anything I could try for cycle 2 for a better chance of success, or are my chances poor (please be honest, this process has been heart breaking)? Any recommendations would really be appreciated!

I am 36, DH is 37.
My day 3 pretesting results were:
AFC = 15
FSH = 6.2IU/L
AMH = 4.94ng/ml or 35.3pmol/L
estradiol = 119pmol/L or 32.4pg/mL
LH = 6.56IU/L
My TSH was high at 5.8, am on eltroxin and was down to 2.8 before ER.
VITAMINS = ubiquinol 600mg, fish oil, prenatal vitamin. Diet was low carb, high protein. drinking decaf and no alcohol.
My BMI is 22.4.

DH's results were poor - below normal in every category except for volume. It surprised us as we have 2 kids and never suspected we had any fertility issues.

My medications were:
BCP for 20 days, started 1st september
started 5 units of buserelin on the 16th september
Started Gonal F 150IU and menopur 75IU, and 2.5 units of buserelin on the 26th September.

Estradiol measured on 22th September as under 18pmol/L and on the 29th September as 1356pmol/L.

30th September - Gonal F reduced to 125 - other meds stayed the same
3rd October, estradiol = 2075, progesterone = 0.604ng/ml. Gonal F reduced to 75 - other meds stayed the same
4th october, estradiol = 2393, progesterone = 0.647ng/ml.
5th October - egg retrieval - 23 eggs retrieved, 17 fertilised, only 3 made it to day 5 biopsy - all opposite gender and only one normal.

Things I am thinking...... my AMH looks high, i have never been diagnosed with PCOS but have always had irregular periods. Insulin resistance test done and it was fine. could i be borderline PCOS?
The dramatic drop from 17 to 3 eggs - i believe they were doing ok until day three - is this down to poor sperm. Last cycle icsi was done, is this enough?
one last thought - was my increase in estradiol too fast? does that make a difference?

Thanks a million xx

[nicoler]

Did you get a chance to speak with Dr Potter? Did he have any words of wisdom? You had great numbers, which is a wonderful thing! It's pretty hard to pinpoint why you lost so many embryos between fertilization and day 5. It could be egg quality issues or sperm, it's just hard to know. My first cycle was a bust as well- I was similar to you in that my follicles took off really fast and I had drastic Gonal F reductions right away. With cycle 2 we tried a different protocol and I was started at a lower Gonal dose, and that helped a lot with my normal rate. I'm not insulin resistant, but Dr P did put me on metformin.

One (or maybe 2 if you are lucky) normals from three tested embryos would be what you would expect around 36 years of age. Depending on age you can expect to have about 50% of biopsied embryos come back as normal.

I do think you can find luck if you cycle again. A new protocol can make a world of difference. I'm not well versed in all the supplements for egg quality so hopefully others will chime in with some recommendations for you. I totally understand how difficult it is to have an unsuccessful cycle. The only thing that really helped me get over it was to throw myself into planning cycle #2. Take care

[nuthinbutpink]

Genes from the sperm do not play a role in embryo growth and development until day 3 so sperm quality could be to blame for the drop off. I would get DH on a supplement now if you haven't and it can help with that.

[babyprince]

Nicoler, thanks so much for your reply. Dr P hasn't said much yet, have my phone call with him next week, so trying to get my questions ready. I'm wondering will dr P know from the ER whether the issue is egg quality. Thanks so much for your help, it's given me food for thought x


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[babyprince]

Nuthinbutpink, thanks very much for your reply. Cycle no 2 will be using frozen sperm, I will be going solo and doing a FET. Last time we made a family holiday out of it, but can't do that again. Plus I want to go home straight after ER, don't want to hang around to hear NT again. I had DH on really expensive supplements for 3 months beforehand. Not cyvita though as you can't get it in the UK. As I will be using frozen sperm is there any better diagnostic tool, more accurate than ICSI, that HRC can use to pick out the best sperm? Thanks x


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[adnilleinad]

I don't have much to add as I had quite the opposite results in my 4(!) cycles. I only got around 9-13 follicles but out of them 70% survived to testing. However on my worse cycles only 1/9, 1/8 were healthy. That is something you cannot control dr p said to me. The other 2 cycles 3/5 and 3/9 (if remember correctly were healthy). So basically quality was good, (looking good and growing) but non healthy. I did low carb throughout my cycles. Dr p was very happy about that. Maybe give it a try? Plus q10 high doze. Perhaps in your case it's your dh sperm, and in that case having frozen it, nothing you can do.

[babyprince]

Thanks adnilleinad, yeah I did the low carb high protein diet ( I ate a lot of cheese for protein, maybe that was wrong!) with 600mg of coenzyme Q10 for 3 months. Hard to figure what else I can do. Best of luck with your next cycle x


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[adnilleinad]

Well then, just keep going I suppose. I did not do high protein. Just "normal". Although I did lchf (low carb high fat), as I needed to loose a bit of weight aswell.
No more cycles for me! Baby girl arrived in June.
I wish you the best of luck. And remember, it could have been your preferred gender last time and that would have been it! If it stuck. So hopefully better luck next time.

Thanks adnilleinad, yeah I did the low carb high protein diet ( I ate a lot of cheese for protein, maybe that was wrong!) with 600mg of coenzyme Q10 for 3 months. Hard to figure what else I can do. Best of luck with your next cycle x


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[babyprince]

Ah wow adnilleinad! Congrats, it's so lovely to hear happy endings! At times, i think it's hopeless, it won't work for me. But happy stories like yours, give me hope x


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[BoyMomX3]

Perhaps a different protocol and add in metformin. I was out on it right before my cycle for ER due to my high afc...my blood sugars are boarder line pre diabetic so the metformin was to help that and in turn help quality!!

Also maybe higher dose of CoQ10 for both you and hubby!


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