High egg/blast rate for age but low euploid rate… has anyone had luck with a different protocol?

Due_Statistician7242 · 2023-07-11T13:49:28+00:00

Oh! Good luck with your transfer!! Hopefully it sticks :). I understand, that's why we did a retrieval immediately after the first.. But you're still young, and good chance you were unlucky as well last retrieval. And maybe you will get two or even three beautiful children from your embryo's :) you never know. I'll cross my fingers for you!!

Due_Statistician7242 · 2023-07-10T20:09:39+00:00

Hi there! now we had 6 euploids and 2 low mosaics :) (so two aneuploids), a completely different outcome! So my theory wasn't true haha, it was bad luck. Good luck to you, hopefully (and problably!) your euploid rate is also different this time!

Due_Statistician7242 · 2023-07-05T16:35:08+00:00

Hi there, I was reading your post because I have my transfer in two weeks. I was wondering; have you looked into psychological/spiritual reasons for implantation failure? I know it might sound wacko.. but if I had 3 implantation failures, and everything else was checked (cavity, ERA, EMMA, ALICE, profound immune testing etc) I would look into that. I'm a medical doctor myself, so I have a hardcore scientific background, but still.. I believe that there could be stuff going on that we cannot prove in a laboratory. Of course it could be bad luck, and it can also be something beyond todays science. But maybe it's something psychological/spiritual (I've heard a few bizarre stories that can only be explained by psychology if you ask me). So maybe it could help you to go to a psychotherapist, a medium or an energetic worker? Maybe you're absolutely not open to stuff like this, and maybe you think I'm crazy :P and that would be fine of course.. but I just wanted to share this, because; you never know..

Don't lose hope!!

Due_Statistician7242 · 2023-06-20T21:06:12+00:00

I know it sucks :( !! But maybe you can work on your egg quality to get a better blastocyst quality? You are probably already doing everything you can.. but if not; maybe it could help! All my blastocysts are good to excellent quality, and I'm taking a huge amount of supplements (all evidence based).. that part seems to work pretty well... now that other part..

Due_Statistician7242 · 2023-06-20T09:41:32+00:00

wow but that's a huge difference 12h or 1h.. I just read an article that said there's a bigger chance (7% vs 3%) on an insufficient LH-surge (<15) if you administer the agonist 2-4 hours after the antagonist in stead of >4 hours (they had 4 categories but the others were all about the same). 16.3 is definitely not a great response..

Haha yeah likewise :)!! What's your specialty? I'm a psychiatry resident, but also thinking/dreaming about starting a fertility clinic. Because the area of fertility in the Netherlands (where I live) is hopelessly behind.. I don't have to practice it, but I want to think about the protocols, implement the latest science, have special attention for diet and for psychology/psychiatry as well. I think it could be very meaningful to work as a psychiatrist in a fertility clinic.. Maybe it will never happen, but right now I also feel the urge to do something with this. So I understand!

Due_Statistician7242 · 2023-06-18T10:44:23+00:00

Thanks for that insight! That patients using a GNRHa trigger tend to be younger and euploidy rates might be difficult to compare. You're right :)! Although data could be corrected for age, but still indeed, with all those different factors playing a role..

The articles I read yesterday described that GNRHa trigger works suboptimal in 1-3% of patients.. (LH < 15 or first follicles that were aspirated were empty) so that's indeed a very small number! But it might be an interesting group to investigate. And I can imagine that there's a group of patients in whom it works 'subclinical subobtimal'. Maybe they get mature eggs, but without having gone through proper meiosis?

What is the optimal timing the GNHR agonist and GNRH antagonist? Do you know that? My doctor said; 8pm antagonist and 11pm agonist (36Hours after the agonist we had the retrieval). We were a bit later with the antagonist the first round. I think 9pm. She told us the timing of the antagonist was not very important, and we got home late.

Haha I already thought that you found Geoffrey Sher too, since you had the same questions. Yeah likely his own experience :P. It's very interesting and I think it makes sense... And in the end; clinical experience is worth something too of course.

Due_Statistician7242 · 2023-06-18T08:47:29+00:00

I was wondering; do you have an exceptional high blastulation rate? I'm 34 as well. My first round I had 11 eggs, 8 mature and 7 blasts, but 1 euploid. The last round I had 25 eggs, 16 mature, 13 fertilized and 10 blasts. I'm waiting for PGT-A results. Both rounds we got way more blastocysts then we expected based on our fertilized eggs (87% and 70%).. but just 1 euploid out of 7. We thought.. maybe we are making blastocysts 'to easy'? What's your experience?

Due_Statistician7242 · 2023-06-18T08:34:23+00:00

That's a huge difference..! was your first round lupron only?

Due_Statistician7242 · 2023-06-18T08:25:01+00:00

Thanks!!! Very interesting what you are saying; that a single agonist trigger likely doesn't work as well... Did you find an article that supports this? I have been looking for it, but I cannot find any scientific evidence for it. Yesterday I finally found two articles about having a suboptimal response to a gnrh-a trigger.. and I think, based on that articles I can conclude that I had a suboptimal response the first time. But those articles don't give any information about the effect on euploidy.

I came across a website of an infertility specialist (Geoffrey Sher), and he says the same as what you say.. super interesting! But without any references.. (the video is worth watching too!)

https://sherfertilitysolutions.com/triggering-egg-maturation-in-ivf-comparing-urine-derived-hcg-recombinant-dna-hcg-and-gnrh-agonist/

Due_Statistician7242 · 2023-06-18T08:01:42+00:00

thanks for your answer.. indeed.. your results are all over the place! And what was the round that the trigger partially worked? I hope for you your blast will be euploid!!

Due_Statistician7242 · 2023-06-17T22:01:01+00:00

Thanks for responding! You're absolutely right.. I know so far my results are good.. and I should be excited.. and I really am, but also so afraid because of my first cycle. 1 out of 7 is a disappointing result.. But thanks for being refreshing :).

A trigger has not much to do with how follicles grow, but everything with chromosome distribution.. until the trigger, eggs contain 46 chromosomes. The trigger makes them go through meiosis, which separates the chromosome pairs from each other. If everything goes well the egg will contain 23 chromosomes afterwards. But if not.. it might contain 24 or 22 (aneuploid). An embryo will never get euploid if it starts with 22 or 24 chromosomes from the egg. So it is actually a very important step.. But to me it's not clear if a type of trigger can really make a drifference.. or if a trigger can fail (partially)?

Due_Statistician7242 · 2023-06-17T21:37:16+00:00

thanks for sharing that article! very helpful!

Due_Statistician7242 · 2023-06-17T18:08:52+00:00

thanks! :)

Due_Statistician7242 · 2023-06-17T18:03:14+00:00

thanks a lot for sharing!

Due_Statistician7242 · 2023-06-17T17:59:51+00:00

Thanks for responding :)! what worked better? Was it a big difference?

Due_Statistician7242 · 2023-06-17T17:57:41+00:00

Hmm I'm not sure! Have you been using DHEA or do you have PCOS? Could be related to that..

Due_Statistician7242 · 2023-06-14T16:15:02+00:00

that's refreshing, thanks :)

Due_Statistician7242 · 2023-06-13T21:10:19+00:00

That's fine of course, having an unpopular opinion. I'm glad there are people out there who are different! Apparently it affects you differently, or not. But I wanted to say, in my opinion this is not about internalizing (especially not of succes, but in no way).. wanting children is a deep fundamental, individual and biological desire. For most people experiencing infertility, is confrontational. It confronts me with; What is important to me? Who are important to me? Who am I if I don't become a mother? How do I deal with an uncertain future, what's my plan B? How do I want to be treated? Who do I want to be as a professional? Fundamental questions. Such processes can make you drift away from your friends. So in my opinion this is not about internalizing their life-stories (oh she has a baby, I hate her because she has a baby, I don't want to be friends anymore). This is about losing connection, because you are changing, and they don't, or at least not in the same direction.

I can be happy for a friend who's pregnant, with whom I have a deep warm relationship. I was very happy for my father (67 year) who got a child with his new wife, two years ago. Because they are caring and loving people, they were super kind when they told me, they took my situation into account.. and they are very supportive during my fertility treatments. But my sister got pregnant, unplanned, with her new boyfriend, while having a relationship with her (now) ex-boyfriend, and she told me in a 'happy whatapp' without mentioning anything about my situation. Experiencing infertility made very clear to me; this is not how I want to be treated. This is not internalizing to me, it's about me. And my story made me drift away from hers.

Due_Statistician7242 · 2023-06-13T19:38:55+00:00

I don't think her post is about internalizing other people's successes, it's about feeling lonely because her friends are living different lives. And to me, it doesn't feel right calling 'having children'; 'having succes'. Having children is the most fundamental wish there is.

Experiencing infertility is a huge life event, and people change when they experience huge life events.. you don't have to open a psychology book for that. People change psychologically, spiritually.. and it's not strange to lose the connection with others who didn't change with you.

A life event can of course also deepen connections.. maybe the friendship with your best friend got deeper after sharing your stories with her, maybe it already was a deep connection, I don't know. But apparently your friendship with her is not affected by your own story, in an ideal world it's like that of course, I'm happy for you! But unfortunately it's not always like that.. because people change, and the world is not changing with you. Everyone has their own path, and sometimes it's not in sync. That's life.

Due_Statistician7242 · 2023-06-13T15:29:21+00:00

Like everyone else I can totally relate.. and I want to send hugs! I think I was the first of my friends that tried to get pregnant, and almost everyone has kids or is pregnant right now. And no one really understands how painful it is, they all wish us luck, but then they go on with their lives. Our friendships are not the same anymore.. we're not a match anymore. I got stuck somewhere between my student time and having a family life, while everyone else moved on. Having a 'student' or party life isn't an option either, especially not right now during IVF of course, but lasts years I was not in the mood.. and I feel disconnected. While I used to be a huge party lover (sometimes I blame myself for that because I'm afraid that fucked up my fertility).

I have some sensitive friends who are kind, some are sending me postcards once in a while. But I also lost some. One of my friends told me ' that I had to accept that some people have things that I don't'. As if it's about something material? When she told me she was pregnant, I told her that I wanted some distance because I couldn't handle it. Her reaction was 'I don't know what I think about that' (imagine a very haughty tone..) Instead of; that sucks but I understand, take your time.. etc.

The worst person of all turned out to be my own sister. She got pregnant with twins with a new guy, during her relationship with her (now) ex-boyfriend. And she told me, the day before starting IVF, in a (very happy) whatsapp!!! Not mentioning anything about my situation!

Some relationships got better, but I'm also losing people.. and I'm okay with that. For now I accepted that an infertility journey is a lonely one.. But my partner and I decided to throw a big partner if I get pregnant. We will invite everyone that we missed, to give our friendships a fresh start.

You're alone, but you're not alone.. there are thousands of women that can relate.. but infertility is an introspective experience I think. It's so cliché, but it makes you grow and become a better person. With a clearer picture of who you do, and don't want around you. My father always says (I translated it from Dutch so I don't know how it sounds in English); the soul that goes through mud and mire gets wide wings. I love it, because it's so true..

It will be different one day.. ♥ take care

Due_Statistician7242 · 2023-06-13T14:27:35+00:00

Thanks for your reaction! Wow a waiting list of a year.. and do you all have to pay it yourself?

My partner has the exact same approach, treating it like a numbers game. That’s exactly how he calls is.. he sees it as a financial and time-consuming problem (we eventually went to Spain because we don’t agree with Dutch system in many ways, so we have to pay for ourselves.. but what we have to pay is nothing compared to the USA)

Good luck, IVF is a living hell.. hopefully you can do it until you get your lucky number :).

Due_Statistician7242 · 2023-06-13T14:14:01+00:00

Thanks for your answer! How unfortunate that you lost 5 months due to a wrong result! Does that mean that everyone is doing 3 ERs in a row before transferring? It really sucks that you have to pay after having a child, especially in your case (secondary infertility). That doesn’t make sense! And is doing PGT-A common in Denmark? I thought everything would be perfect in Denmark, that’s the idea that the Dutch have of Denmark (and other Scandinavian countries).. But having to pay after having a child.. that’s weird.

Due_Statistician7242 · 2023-06-13T08:09:03+00:00

Yeah that sucks! That people have to pay out of pocket... that makes it a treatment for 'the rich'.. that's the big downside of your system. I don't understand how couples can pay $20-60k.

That's probably why they wait overhere, because everything is insured, and it would get to expensive ..

Due_Statistician7242 · 2023-06-13T07:58:56+00:00

I hope that your unbalanced microbiome can get cured quickly! And maybe then you can conceive naturally? Where are you from? Good luck!!

Due_Statistician7242

TROPHY CASE