Poor embryo quality due to eggs?

Discussion forum for those particularly interested in IVF and embryo transfer including frozen embryo transfer.
snemo
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Poor embryo quality due to eggs?

Post by snemo »

I just spoke with my RE this morning about my poor egg quality.
Turns out that he said that my egg quality was poor because all the embryos were of low quality after fertilization. I had to do a transfer at day 3. My husband has a low sperm count, morphology, motility and antisperm antibodies. But still he says that if the embryos were poor at 3 days it's mostly the egg and not the sperm.
I am 30 and have no problems with ovulation or with any of my test results. I miscarried with my first IVF and that was supposedly to poor egg quality.
Is it all just about the egg and not the sperm?
My RE recommends using donor sperm but I thought that was too drastic. I had second opinions from other REs and they said that if the sperm is of poor quality it can effect the embryo quality.

Any advice would help. I can't stop thinking about my egg quality and poor it is and how I can't believe this is happening to me. Is it all just a nightmare? Or is it just that I am in complete denial.

We TTC 9 months on our own till we found out about my husband. Then we did IVF with ICSI and I miscarried. Is one try enough to determine the cause of our infertility besides the sperm? We are thinking of using donor sperm and doing an IUI instead but the RE didn't think it was a great idea with my egg quality.

Too much information and no hope.

Snemo
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fmj
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Post by fmj »

Hi -

I'm not sure the answer but I'm in the exact same situation. We started down this road due to my husband. Everything is believed to be normal with me. We did ICSI in April and with 9 eggs retreived, 8 fetilized, but we had just barely 2 to put back in. We had to do assisted hatching on one. Unfortunately, we ended up with a negative result. I asked the doctor if I have an egg problem and he said he wouldn't jump to that conclusion just yet. He said it just could have been a bad month for eggs. He said he thought we should give it another try. In what I've read, the embryo quality is really a combination of the sperm and the egg. Although, with ICSI, they do pick the best sperm, but I've heard that even though it looks normal, when a man has issues, it may not make a difference. I don't know. But we gave it another try - I actually go for my blood test on Monday! This time around, I did just about anything I could - ate only organic, cut out refined sugars, added acupuncture - and I will say I felt really healthy going in. They did the exact same protocol. The result was 8 eggs retreived and all 8 fertilized with ICSI. In the end, we had 2 to put back in that were much better quality than last time, but none left to freeze - they seemed to be developing too slow. They watched 3 of them for another few days, but they just didn't get to freezing quality. I have not even thought to ask the doctor if he now thinks I have a problem with my eggs - I don't want to know. I'm trying to stay positive and really hoping for the best this time. I would give it another try before moving to donor sperm - that seems a little extreme after just one time for your doctor to jump to that conclusion. Don't loose hope. When you read about women on this website in what seems to be hopeless situations that become preganant - it just inspires me to keep the faith. Hopefully you will do the same. Best of luck to you.
snemo
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Post by snemo »

I totally understand. I am so sorry for all that you are going through too. All the best to you and your husband.
I just don't understand how one doctor says it's the eggs bc the embryos were so fragmented by day 3 and the other doctor saying that it could be the sperm quality too.
I just can't go through another IVF. My body didn't handle it very well. I responded well to all the meds but still my body was just not liking it. I want to do another IUI but with all that we have learned our current RE says our chances are really low with my Dh sperm. If we use donor, we should have about 20% chance. It's worth a shot eh? Donor sperm is extreme, I think so too but I think donor eggs are even more extreme. That's what my doc recommended. Donor eggs are 30K plus it's hard to come by vs sperm isn't. So if worse comes to worse, I say donor sperm.

Good luck to you and if you ever need to chat
here is my email
msshino@hotmail.com
Snemo
1st IVF BFP
M/c at 7 weeks 5/16/07
kellym
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Post by kellym »

Hi,
I am having a similar struggle. I have now been through 5 IVF cycles, all fresh. We know that my DH has low count, low motility, etc but it is due to a vasectomy reversal (he has children from a previous marriage). When we first started we were supposed to be an easy case because as we were told we aren't considered an infertile couple since it is due to the vasectomy reversal. However, here we are 2 years later, 5 IVF cycles and no babies. I have had 3 chemical pregnancies and 2 BFN. On my 4th attempt the lab reported some slight abnormalities in my eggs, but on the 5th attempt they said the eggs looked good. My RE said that poor eggs during one cycles does not mean poor egg quality all the time.

Here is my history...
Cycle #1 - 12 eggs, 9 fertilized, 2 transferred on day 3, none left to freeze... chemical pregnancy
Cycle #2 - 6 eggs, 1 fertilized, 1 tranferred on day 3...bfn
Cycle #3 - 11 eggs, 10 fertilized, 3 transferred on day 3, none left to freeze by day 5...bfn
Switched cliinics...
Cycle #4 - 8 eggs, 7 fertilized, 4 tranferred on day 3, 3 frozen... chemical pregnancy
Cycle #5 - 11 eggs, 10 fertilized, 3 tranferred on day 5, 3 frozen... chemical pregnany

My RE says that my egg and fertilization numbers are fine and since I am 35 I should be getting pregnant! But I am not... So, here are I wondering what to try next. We do have 3 frozen blasts so we'll use those in August but if that doesn't work what next?

I don't know if the problem is the sperm (which it shouldn't be if the only reason there are problems with it is because of the vasectomy) or the eggs. One cycle the eggs are a problem and the next cycle all looks good. So, is it my body? Should I get a surrogate, donor eggs, donor sperm or donor embryos? I just want a baby...
fmj
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Post by fmj »

snemo -

I know what you mean about the IVF's - totally draining on both a physical and emotional level. And I will warn you that the second round is worse. I was so nervous the entire time knowing where things could take a turn for the worst. Not to mention you know how bad it will hurt if it doesn't work. The first time I went in a bit naive, not knowing what to expect and excited. I thought this was the solution to our problem and then when it didn't work, I felt like the rug was pulled out from under me. As far as what you should do next - everyone is different. I couldn't imagine not trying it again. Although, you need to do what is best for you - maybe if you wait a while you will be ready for another IVF. If not, I would go with the donor sperm route before I would consider donor eggs. I can't believe your doctor would jump to that after just one failed IVF. Have you gotten a second opinion? Good luck to you in whatever you decide.


kellym -

I am really hoping your FET works out after everything you have been through. To see all that you have endured really breaks my heart. Lets hope this is the one. My girlfriend had a FET a few weeks ago and just found out she is having twins!

As far as what you can do to prepare, I'm not an expert, but this time around I started seeing an acupuncturist who specializes in infertility. She recommended I read this book "The Infertility Cure" by Randine Lewis. It is an amazing book - very eye opening. I learned so much about my body and how everything works. It focuses on the Chinese medicine approach to infertility through, diet, herbs, and acupuncture. It helps identify deficiencies in your body. I didn't get into any of the herbs, as I was starting my IVF cycle and the doctors don't like you on herbs, but I followed the diet recommendations and incorporated acupuncture. I'm not sure if it made a difference (I'll know on Monday) Although, I will say, I've felt really good and I'm going to continue with the diet recommendations. There are also a lot of very inspiring success stories. It helps you understand what might be happening in your body that is preventing you from becomming pregnant. For those that have to go through IVF regardless, there is also a section in the book about how Chinese medicine can complement your procedures. Good luck to you - I hope this is the one.
snemo
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Location: Colorado

Post by snemo »

Kellym,

I totally understand what you are going through. From what you are telling me it could be the sperm or the egg. But unless you have had tests tell you that you may have poor egg quality such as CCT or high FSH levels, I would suspect the sperm. However, the only way to figure out if it's the sperm is to inject it into an egg and find out the embryo quality. So unless you fertilized half of your eggs with donor sperm and then the rest with your husbands there is no way of knowing.
That's where I tend to get stuck. I have no idea of what to do about that. No one else seems to think it's the sperm but me. Doctor's do day that the paternal DNA kicks in after day 3. So with us doing the transfer on day 3 should mean that it's the egg.
However my second opinion doctor looked at my dh's numbers and thought it could be the sperm.

We are going to try IUIs once I do my HSG (hopefully open). Have you guys thought about IUIs with donor sperm?

I truly believe that you know your body the best. Though RE's know a lot they really believe in their protocols and procedures as well. I know for a fact that my body hates all the meds for IVF. After 3 months off of my meds, I still feel horrible. So I think we are going to resort to IUIs for a while with donor sperm. If that doesn't work we will have to try IVF again but I may have them do half donor and half dh. It may not be fair to the hubby but in reality eggs are harder to come by than sperm.

I feel that your eggs are great and if not in one batch there are some in another. So hang in there and believe in your body. You are a healthy women and no one will stop you from getting pregs.

For me just thinking that I am a healthy person helps me get thougth the day without wondering what else may be wrong with me.

Take care and please email me if you would like to talk.

Sincerely
Snemo
Snemo
1st IVF BFP
M/c at 7 weeks 5/16/07
snemo
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Post by snemo »

I forgot to mention that I read on the internet that the paternal DNA could kick in on day 2 as well. So just because you do a day 3 transfer doesn't mean that it's the eggs. It could be the sperm as well.

REs tend to think that the sperm if fine because they are doing ICSI selecting for the best sperm. However, if there is problems with the sperm to begin with, just injecting it into the egg really doesn't resolve anything. They are just fertilizing the egg not worrying about the content of the sperm. ICSI can't be the solution for male factor infertility.

I feel that the blame is always put on the women and not on the male. Why is that? I can understand if the REs detect a problem with egg quality in their tests, but otherwise if they don't see the quality of the eggs upon retreival can they really say that they are bad.

I asked for my embryology report upon retrieval. They didn't grade them or suspect anything then. They just fertilized them and then graded the embryos on day 3. I still don't get how they could just say it's the egg.

If anyone has a definite answer about this, please let me know. I feel that the doctors has day 3 embedded in their head so they can't think outside the box.

Good luck to you all. I know this may sound harsh to some of your but I truly believe that if I used donor sperm for my IVf cycle we would have done better.

snemo
Snemo
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M/c at 7 weeks 5/16/07
kellym
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Post by kellym »

Hi Snemo,

I am still truly confused. My embryos generally progress well (cerainly the last few cycles) and have been grade 1 or 2 (grade 1 is best in my clinic) embryos. that is what confuses me. If the embryos appear to be developing well at day 3 and then at day 5 (as was the case in my 5th attempt) can the eggs and/or sperm really be bad?
For my FET in August I am going to ask that they monitor my hormone levels throughout the 2ww because I feel as though a day or two before I start to bleed my hormone levels drastically plummit. Some have said that it is because my body rejected teh embryos so it was preparing for miscarriage but I wonder if the levels drop, then my body miscarries. If my levels come back normal then I can only think that the problem lies within the embryo - the sperm, the egg or the embryo itself. But no one can answer that question.
I actually had never thought that I could do IUI with donor sperm. Have you done IUIs? Do they still give you stimulation drugs? That sure is something to think about before doing down the road of getting donor eggs. The only thing is that I think that I am more open to donor eggs than my husband is to donor sperm so we'll have to talk about that.
What is a CCT test? My FSH levels are normal so that doesn't appear to be the problem, my eggs fertilize and they develop well.
Do you know whether you can have normal eggs, normal sperm but together they create abnormal embryos? So, it is neither the eggs nor the sperm on their own but rather together that cause the problem?
Obviously I have many unanswered questions.
Ghost
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Post by Ghost »

Have not read all the posts, but just want to add 2 cents:

The first few days of embryo development are dominated by maternal DNA from the egg. From day 4, paternal DNA from the sperm starts to kick in, or so I've been told (I'm no embryologist). That is why they think poor development on day 2 or 3 might be attributed to the egg, not the sperm.
kellym
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Post by kellym »

Ghost,
Does that mean that if the embryos make it to day 3 and are considered good quality embryos (8 cell, grade 1) that the problem isn't likely the eggs?
JADE0199
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Post by JADE0199 »

hi girls
This thread is the most intense and most informative I've read in a long time. However, I want to tell all of you that I am sorry for each and every one of our struggles in our TTC journey. ((hugs)))

I know how frustrating the disappointment and heartache can be. Just alittle about me..

I am 36, will be 37 on 8/2. DH is 34 and has no sperm issues. Since TTC #1 since Sept 05, I've suffered 3 m/c's and a chem. pg. All the losses occurred before 8 weeks and never saw the heartbeat on any of them. Had a complete infertility workup with the RE in Oct 06 and have no issues.
FSH 6.1 E2 normal, all other blood work levels normal.

We then tried IVF w/PGD (preimplantation genetic diagnosis) in hopes that we would retrieve many more better quality eggs and then biopsy them to sort out the normal from abnormal. But that didn't work out as planned and cancelled PGD on Day 2 because we only had 4 fert. embies that were 2 cell stage. I believe were developing slowly.On a side note, PGD was not covered by our insurance and cost between $5-$6K. Fortunately, most of it was refunded. We then transferred 2 embies, 1-7 cell Grade 2 and 1-5 cell Grade 1 (the best) on Day 3. This ended in a BFN. :(

I just wanted to forward some information I found on the internet when I researched age and egg quality. There was also a time when I thought it could be DH's sperm possibly being the problem but with all the literature that I've read, it seems to be the quality of the egg that is the cause of poor quality embryo's, failed implantation, miscarriages and failed IVF cycles. What I've also learned is that your FSH level does not indicate the quality of a woman's eggs, only the reserve.

Check out these links if you are interested...I found them very interesting and contained information not in any of my books.

http://www.pregnancy-info.net/infertili ... ality.html

http://www.advancedfertility.com/eggquantityquality.htm


With all that said, we have decided to move onto donor egg. And it can be less costly than you imagine as the clinics have many options out there to chose from. They have shared cycles, where a woman goes thru an IVF cycle and shares her eggs with the cost of the cycle (50/50), or you can be matched within your clinic with a donor. My clinic only charged $3K donor fee (her compensation for time, discomfort, etc. donors do not get paid for they're eggs). Downside is that the wait can be long, as long as 6 months or more. The more expensive route is going thru a Donor Agency, which is what we did, and we chose our donor by reviewing her bio and photos over the internet. Its all very private, confidential and professional. I hope you find this info helpful and wish you all the best of luck!! Hoping and praying for all of us to have our BFPs here. If you have any questions, feel free to ask.

Thanks for letting me share.
Cathy
[size=75]TTC #1 since Sept 05
• early m/c 12/05 twins • early m/c 6/06
• Chemical pg 9/06 • RE 10/06 • early m/c 2/26/07
• IVF#1 May 07-BFN • IVF#2 w/DE-10/07[/size]
[img]http://img.photobucket.com/albums/v653/teendoc/Blinkies/donoreggs.gif[/img]
Ghost
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Post by Ghost »

kellym wrote:Ghost,
Does that mean that if the embryos make it to day 3 and are considered good quality embryos (8 cell, grade 1) that the problem isn't likely the eggs?
I don't think you can go quite that far. That case would only imply that any problems with the maternal DNA in the egg, if there is any problem at all, was not seen before day 3, but still could have an impact later.

All I'm saying is that I've been told that paternal DNA has little or no effect until day 4 or 5. Before that it's maternal. After that, it's both.
beachbaby
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Post by beachbaby »

Hi ladies, I am so sorry for all your problems, we are currently awaiting further test results after 2 chemical pregnancies.i have 4 frosties left, once i've used those, if i need to on my next cycle i am seriuosly thinking of doing PDG, so i know all embies are healthy or i get none i know its the end of the road for us. and we can move on with our life together.

Snemo, your RE sounds very harsh, after one ivf cycle to say its the egg quality is pretty rough going. you did get pregnant, which means you can get pregnant with your eggs and DH sperm. In england at my clinic with the sperm issues your husband has you would only have the option of icsi, we only have minor sperm issues but due to there being two problems we had to do icsi. your first go really gives them a good idea how you react to the drugs, so they can adjust them next time if necessary. I know you sufferd badly with the drugs but maybe a different combination would be better for you, and have you thought of trying PDG, this will then put your mind at rest that you need to go down the donor route, as this would wheedle out all the abnormal embryo's. I wish you all the luck for the future and hope you get your dream.

to all the other ladies, i hope all your dreams come true, keep the faith.
J
Me 39, DH 40. TTC 5years
4th times a charm,1-IVF, 3xFET's, 2 chemical
Twin boys born 9/7/08
snemo
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Post by snemo »

Hi ladies,

I do believe that embryo quality is effected by the egg and the sperm. I just can't say that day 3 is the magic number for all. I just wish that my RE would give us another chance.

Donor sperm just seems like our first option since I don't think we can come up with another 35k for donor eggs. And though my eggs could be bad, I don't believe that they were given a fair chance. So I decided to take on IUI and donor sperm with a vengence. I am so eager to see what happens.

I spoke to another RE and told him about our case (he has all our information) and he said to either give IVF another chance or try IUI with DH or donor sperm. He also told us that I hyperstimulated which can effect egg quality as well. So I'm hoping that there is a small chance of success.

My DH is not too keen on using donor sperm either. But I do have a little leverage since his mother was artificially inseminated too. I don't know what it is with men. My DH was eager to use donor eggs but not vice versa. I didn't think that was fair. Anyways, in reality eggs are a lot harder to come by than sperm. Just my two cents.

Praying for you all and good luck. I am truly sorry if this thread got too intense, but no matter where I looked I couldn't find any information about egg quality to the extent that I was looking for.

Good luck ladies!

snemo
Snemo
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M/c at 7 weeks 5/16/07
kellym
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Post by kellym »

Snemo,
Please don't apologize for this thread being intense. It has been one of the most useful I have read because the issue is very confusing and quite honestly is the biggest question in my mind. It has helped me deal with my situation and to understand what my next steps may be. In fact I never considered trying IUI with donor sperm. A much easier and more cost effective procedure.
As for the egg donor issue, I know that you can go to overseas clinics and save a bundle. We have looked into a clinic in Czech Republic which has a good reputation (we have Czech friends who checked it out for us on their end) and has had US and Canadian couples go for procedures. For donor eggs it takes only 2-3 months - you get to select your donor - and the cost is around $8,000. That includes all the procedures (IVF/ICSI, assisted hatching, donor eggs), drugs, hotel and flight for the trip over. I was shocked when I found out the price but it is so much cheaper and still just as good. Their stats are great! Something to consider if you are looking at donor eggs. I am Canadian and finding someone to donate eggs is virtually impossible so we have to look outside of our country. This is a good solution for us.
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