The cycle below is showing how my cycles have panned out.
1st fresh cycle went fine with 17 eggs being collected, 10 were mature of which 6 fertilised and divided and 2 where put back at day 2 (4 cells grade 1 – 2 and 2) none of the remaining were suitable for freezing so under grade 3 but failed to result in a BFN.
The 2nd fresh cycle lead to 21 eggs being collected and having a freeze all at day 1 due to risk of OHSS out of which 10 eggs fertilised and were all frozen at the 2pn stage.
The first FET we unfroze 5 embryos, 5 of which made it through the thawing process, and 2 were replaced at 7 – 8 cells (grade 1-2 and 2-3) on day 3 which resulted in a BFN
After the 1st FET failed we decided to have all of the level 1 & 2 tests carried out on both of us which revealed I had a high NK cell count and both me and my partner share a similar DQ Alpha gene.
The medication given for this was intralipid, clexane and prednisolone.
On the 2nd FET we had the same results as the first and I was on the additional medication - we unfroze 5 embryos, 5 of which made it through the thawing process, and 2 were replaced at 7 – 8 cells (grade 1-2) on day 3 which resulted in a BFN
We did a little further investigation and it turns out that with us both sharing the same DQ alpha cell the best remedy is to only replace 1 embryo so that it is a good chance of not being the one with the same DQ alpha cell.
So we began a fresh cycle in October and this is how it went (badly to say the least!!!)
17/10/13 - Last natural period began
31/1-/13 – Started Suprecur 0.5ml daily on day 14 of my cycle as they are irregular/short cycles usually 23-25 days
11/11/13 – down reg scan cancelled due to no period
14/11/13 – Period started
18/11/13 – Down reg scan showed quite a large cyst on one of my ovaries and lining not thin enough to begin stimulation
Advised – Inject 1 Pregnyl powder with 1 water that night to get rid of the cyst and bring on another period
28/11/13 – Next period started
2/12/13 – Down reg scan cyst had gone and lining was at 5mm,
Advised – Start Menopur 2 powders (150) to 1 water that night
8/12/13 – Started prednisolone 20mg once a day
9/12/13 – Scan showed there were approximately 30-4- follicles all growing at a good pace and uterine lining was at an average of 11-12mm
Advised – Decrease the dose of Menopur down to only 1 powder (75) that night
9/12/13 – Intralipid Infusion
10/12/13 – Normal dose of Menopur 2 powders (150)
11/12/13 – Scan and blood test showed oestrogen levels to be at 21,000 and this was too high to be able to give the final injection and there were approx. 49 follicles half being around the 15-18mm mark
Advised – To start coasting (come off the menopur completely, only taking 0.5ml of suprecur)
Condition – Was feeling very sick, bloated and had headache, all of which was told to the nurse
13/12/13 – Scan and blood test showed oestrogen level dropped to 19,500 and there were approx. 4-5 less follicles showing on the scan
Advised – Ok for collection and arranged final injection (pregnyl) and date for EC
14/12/13 22:00hrs – Final injection administered Pregnyl 2 powder/1 water
16/12/13 10:00am – Egg Collection 17 eggs were collected, only 15 were viable
17/12/13 – Embryologist called to inform me that out of all 15 eggs only 6 were mature enough to fertilise and only 3 did fertilise
Basically what I am trying to find out is that as the number of eggs collected and fertilized on the 2 previous cycles have been quite a high number and more than 50% have fertilised, why this time, when I have been coasted due to high oestrogen levels (21.000) only 15 eggs out of 45 follicles were recovered and only 3 of those fertilized?
Also why if my consultant knew that we had to have a freeze all the embryos on our last fresh cycle (due to risk of OHSS), has he chose to give me the exact same dose of Menopur on this cycle and not decrease it by any, could it be his misdiagnosis of the correct dose that has led to me needing coasting and the egg quality suffering?
Is this just the luck of the draw or is it due to my body overreacting with the medication and the coasting that has made the eggs not mature enough and of a poor quality?
Thank you for your time and any advise to help me understand would be greatly appreciated.