Embryos stopped growing

[vita]

I'm 34 and have been diagnosed with PCOS since 15. We've been trying to get pregnant for more than 5 years now. Tried almost everything: herbs, Clomid (9 times), laparascopy, injections (8 times). I got pregnant twice but the first time baby stopped growing at 9 weeks and second was a chemical pregnancy.
Eventually we decided to try Ivf and had 22 eggs retrieved with 19 fertilised. On day 2 they all looked very good so we were hoping for blastocyst transfer. But on day 3 our embryologist called and said that some of them stopped growing and the rest are very poor quality (lots of fragmentation and 4-5 cells). We decided to transfer 2 best ones (5 and 6 cells, grade 2 with grade 1 being the worst on 1-4 scale) and see if the rest will continue growing. But next day we got a call from our clinic and doctor said that unfortunately all embryos stopped growing.
I'm absolutely devastated and can't stop crying. I think that my poor egg quality was the reason I lost 2 pregnancies. I just wanted to ask you if there is any chance I could get pregnant this cycle? And if not would the quality of embryos be better with next IVF? Or I have a very little chance if all of them stopped growing?
Thank you so much.

[brekkemdb]

Vita-- i can't offer any help as i have no idea why they would stop growing-- i mean a couple i can see but not all of them. maybe some else will have some words of wisdom. i am sorry though that you had to go through this--thinking of you. bridget

[rhonda01]

Vita - I've had 2 failed IVF cycles so far and I think it was because I was overstimulated and that made my egg quality poor - first of all I only have one ovary and I know from reading and from my RE that the ideal # of follies to have is between 10-15 (this maximizes egg quality) - because of my one ovary situation they put me on the highest dose of meds and first cycle I got 37 follies - 24 eggs and 19 fertilized - all were slow growing and by day 3 we only got two 5 cell to transfer - BFN

Next cycle they dropped my dose and I got 27 follies (no where near the 15 they were aiming for) - 22 fertilized and this time we were lucky that 2 made it to blasts on day 5 - none to freeze - but once again another BFN - we were so disappointed because they made us think that blasts was a sure BFP - so now I'm sheduled to do IVF again in January and they're going to lower my dose again and aim for those 10-15 follies - but in my cause our issues are all MF - Dh has extremely low motility - so RE thinks our embie quality (the fact that they are slow growing) might be because of his sperm quality - but they won't know for sure until next cycle when they drop my dose.

I do understand your pain but you have to hang in there - my SIL cycled with me and she has PCOS and she got 29 follies and 17 fertilized and she got only 2 to reach blast stage and she is now pregnant with 1 - so there's always hope!

Of course I'm telling you this and yet I'm feeling pretty hopeless myself so maybe I'll take my own advice!?!?

[vita]

Thank you for Bridget and Rhonda for your kind words. It gives me hope that may be we would be luckier our next IVF cycle. I know that some girls even got pregnant with poor quality embryos and have lovely kids now. I try not to loose hope. Wishing you all the best.
Thanks again

[cbaker111]

Hi Vita - I had a similar experience with my first IVF - I had 18 eggs and 12 embryos and then between day 2 and day 3 all but three stopped growing and the three that we had left were either medium or poor quality. I was told it was because of my age (I was 40 at the time). I consulted with an old MD of mine and he suggested that it might have been due to lab conditions and suggested that I try another lab the next time. About a year later I tried another clinic and got 23 eggs and 19 embryos. Almost no fragmentation in any of them and all good quality. He transferred 4 (as I am now 41) and we had 12 that were good enough quality to freeze. AND, I got a BFP! The new clinic did a somewhat different stimulation protocol in addition to obviously having another lab setup, the technicalities of which I do not know.
I know how you feel - I was so devestated that first time after feeling like all was going so well only to have it all fall apart. And then to be told that it was my age and likely nothing would change the outcome (I was told this by the first clinic) made me feel even worse. But, look what happened at my next cycle! Keep your chin up and I'd try again if this time doesn't work for you.

[vita]

Claudia, I am very grateful for your message. I feel so much better now! I definitely try it again at another clinic. I felt that the stimulation protocol they’ve used this time was not good enough as between days 7 & 9 my follicles didn’t grow at all and clinic increased Gonal-f dose drastically which might be the reason for poor egg quality. I tried to talk to them about it but they still insist that it is due to my PCOS.
But now I know that there is a light at the end of the tunnel.
Thanks again and congratulations on your BFP, have happy 9 months!

[suzhan]

cbaker - your story is very interesting. I was wondering if you wouldn't mind sharing a bit about the difference in stim protocol between cycle #1 and cycle #2 - I've heard the protocol can make a huge difference, as can the skill in the lab. Did you make any other changes at the time as well (i.e., diet, acupuncture, etc)? I just wondered, if you don't mind, to learn a bit more. I too have had issues with egg quality, although my RE said my embies in try #2 (ended in bfn) were much better than with try #1 (he said quality was extremely poor, but still had a bfp that time, later resulting in m/c at 8 weeks).

Thanks in advance and good luck to you all!

[cbaker111]

Vita - on my first IVF, they started out with a low dose b/c of my previously very high response during IUIs and then when they were confident that I was not going to hyperstimulate, they upped the dose, then let me "coast" for a few days before retrieval. When I went to the other clinic and told them the story of my past IVF the doctor frowned and said "hmm, that's a step-up protocol ... we always do a step-down". I didn't ask him for any details but maybe a step-up is associated with lower egg quality and maybe that is why you had embryos that stopped growing, like mine did the first time around.

Suzhan - there were quite a few differences in the stimulation protocols, the first being the actual medications used. My first IVF was in Paraguay while my second was in Brazil (I am stationed overseas for the government). In Paraguay there was no access to the newer, recombinant meds which require only a subcutaneous as opposed to an intramuscular injection so they used the older ones. In Brazil they used Menopur and Gonal-F. In Brazil, I was put on BCPs for one cycle beforehand. They also used a LOWER dose (in absolute terms) throughout (but got more eggs, go figure) starting with a higher dose and tapering down. They proportion of FSH to LH was also a lot higher as, apparently, there is evidence that LH contributes to poor egg quality in older women. They also thought that there was some evidence that I had PCOS and in PCOS LH levels are elevated already. After the transfer they used baby aspirin, estrogen patches, prednisone for two weeks (a weak immune system suppresant) and progesterone suppositories. In Paraguay all they used were progesterone suppositories.
As far as other changes, I only did bed rest for two days after the successful transfer while after the unsuccessful one the MD told me to be on bed rest (more or less) until the test date. No other changes, other than that I prayed a lot the second time around!
Feel free to ask me anything else if you have any other questions!

[suzhan]

Thanks so much. I wasn't aware of the evidence that ties LH to poorer egg quality in older women. I'm on more Gonal-f than Repronex (I think that's the LH?) but not that much more. I wonder if the Repronex might be hurting my egg quality.

Thanks again for the info. Boy, I miss Ghost.....

[rhonda01]

Vita - did you ever try metaformin? I have a mild case of PCOS and my clinic is going to add metaformin to my next cycle - also did they say they could drop your dose of meds to produce less follies? That's what my clinic is doing for me since I produce too many eggs and just like you they grow slow or stop growing. I'm also dealing with MF issues so our embie quality is from both sides.

Rhonda

[vita]

Hi Rhonda,

I started taking Metaformin 11 months ago. I think it is helping me as I never ovulated before and since taking it I ovulated couple of times on my own. But my LH levels are still very high and FSH low.
Regarding stimulation we started at 115ui of Gonal-F for 4 days and by day 5 I already had about 50 follicles size 8-10 so they dropped my dose to 75. On day 7 everything looked good and I had about 15 follicles size 12-15 and lots of small ones. But when I came for the ultrasound on day 9 my follicles almost didn't grow at all so they upped my dose again to 115. I think something unusual happened in these few days as I experienced exactly the same symptoms which I usually get post ovulation (very sore nipples, vaginal discharge changed and so on). I told my doctor that but she pretty much ignored my concerns. Since then I've done some research on Internet and some doctors think that evaluated progesterone levels during stimulation could be the reason for poor egg quality. So I think there is a chance that something went wrong during my stimulation but my doctor still insists that I had a very good response.
Vita