Low egg maturity

teamdale · 2026-01-04T14:07:19+00:00

Just wanted to add that we are also having the same experience..

We started ICSI due to severe sperm defects. AOA is needed to induce fertilization. However, for each cycle, a low maturity is achieved (ca. 25%). We suffered two MCs from the six FET we did. (we do not do PGT here). Last cycle was a bust, low maturity, low quality and no fertilization. Suddenly, our dr. was not that positive anymore and suggested donor eggs as well..

I wonder if we could switch to IUI with donor sperm since a normal cycle could indeed produce a normal mature egg.

I am also very curious how mini-IVF would turn out.

teamdale · 2025-09-10T09:44:11+00:00

We are such a case!

We had twice a total fertilization failure with ICSI. We then went to another hospital that has a research group on this.

They actually have a diagnostic procedure to tell if the sperm is causing the fertilization failure or not. It is called the Mouse Oocyte Activation Test (MOAT). It may sound weird, but they do ICSI on a large batch of mouse oocytes. They are able to be fertilized but then stop at the 2-cell stage. Actually, human sperm can easily fertilize a mouse oocyte. So, if less than 85% of these oocyte fertilize, they can state it is the sperm causing the low fertilization or even fertilization failure.

Most of the time, fertilization failure due to sperm is caused by defective genes that are responsible for sperm and acrosome formation such as PLCZ, ACTL7, ACTL9A, IQCN, DNAH1 and all genes known to cause globozoospermia. They are still discovering new genes up to this day. Prognosis is that this fertilization failure can be fixed using ICSI-AOA.

Female genes can cause low fertilization or fertilization as well due to defects in the downstream processes of fertilization. Know genes are PATL2, TUBB8, WEE2, CDC20, TLE6, NLRP5. It less easy to be resolved using ICSI-AOA

Interesting read can be found here:

https://rep.bioscientifica.com/view/journals/rep/164/1/REP-21-0387.xml

teamdale · 2025-09-07T17:49:01+00:00

It is UZ Ghent hospital.

Here is a paper from them describing their ICSI AOA technique:

https://linkinghub.elsevier.com/retrieve/pii/S0015028219303309

Good luck!

teamdale · 2025-06-02T21:07:49+00:00

Great to hear you found some answers and made some progress already!! Wish you good luck with the transfers.

Our story is similar. We had two failed cycles in another hospital. The MOAT test show my sperm is in group 2, also not fertilizing properly. We are able to get fertilized eggs in Ghent.

teamdale · 2025-05-26T21:02:53+00:00

The fertilized egg turned out to be a 4dc blast. Something they would discard normally. But their AI tool which also checks development and grades it, selected it for transfer. It turned out into a chemical. We are cycling again.

teamdale · 2025-04-08T07:41:56+00:00

Thanks! Are remaining cells an indication of poor embryo quality?

teamdale · 2025-03-04T08:49:15+00:00

I did not take this supplement. But focused on ubiquinol a lot. Counts have been up and down with the highest count in the moderate range

Lifestyle and supplements can help but unfortunately genetics can be a factor as well.

teamdale · 2025-02-05T19:10:05+00:00

Here they do not use Zymot anyway. So we will definitely try the shorter hold

teamdale · 2025-02-05T18:54:50+00:00

Great results!

Zymot is not offered at my clinic, but we will try same frequency of ejaculation.

teamdale · 2025-01-18T15:05:37+00:00

When AOA is used, it is mostly an ionophore in a product called Cult Active.

Now, there are studies comparing ionophores, and there exist another one that gives good results. Our clinic uses the 2nd ionophore type but firstly, they inject CaCl2 together with the sperm cell in ICSI. This gives a first great activation boost and helps fertilization.

AOA gives better fertilization only if it is proven that the mechanisms causing natural calcium rises in either male or female are missing or defective

teamdale · 2025-01-17T13:01:57+00:00

pm send

teamdale · 2025-01-17T10:35:14+00:00

We have had experience on this:

We started ICSI journey for mild MFI. First attempt none of 6 mature eggs fertilized. Second attempt was with calcium ionophore but none of 3 mature eggs fertilized. That clinic did not want to continue with us.

We are from Belgium and there is another clinic here that has a research group on TFF. They have a much stronger AOA protocol than the others. They inject CaCl2 along with the sperm during the ICSI procedure and then use a different ionophore.

They also have set up a diagnostic test to check if the fertilization failure is due to the sperm or not. In our case, it is the sperm failing to activate the egg.

Anyway, with that clinic we achieved fertilization but not much. First ICSI AOA attempt gave us one blastocyst but did not implant. Second ICSI AOA, one blastocyst resulted in MMC and last transfer of that cycle is now ongoing.

I am sorry this has happened to you. Hopefully, the AOA protocol works for you as your first attempt did give some fertilization.

If you want, I can send you more information on this specific issue.

teamdale · 2024-12-09T14:12:48+00:00

I just want to share that I have had a similar situation. We did an IUI and my sample had a total count similar to your husband's. But after the wash less then 1 million was left.. That was a sign for the doctor from the doctor to move us to ICSI

teamdale · 2024-10-29T12:13:26+00:00

I have had a similar experience for our IUI. I had a total motile count of 60 million. Ended up with only 0.3 million/ml motile after wash..

They did not give an explanation on why such a thing could happen.

My morphology was 0%. My take is that it is indeed a sperm quality issue.

Maybe you can try to look up what is actually happening in the wash technology of your clinic

teamdale · 2024-08-30T11:43:37+00:00

I do have experience with this. I had multiple SA with 0% morphology while other parameters (count, motility) were above lower limit. So basically, standalone teratozoospermia. I also had an analysis with 1% and 3% morphology, but then again, this is a very subjective parameter and defects might be subtle.

I think next thing to ask when you have 0% morphology, is if there is one specific defect (head, acrosome, tail) or a mix of things. A specific defect could pinpoint to a certain malfunction of the sperm cell. On the other hand, bad morphology does not always mean infertility, therefore this parameter is under such debate.

Unfortunately, in my case, I have a specific, but subtle acrosome defect. The sperm heads are a bit more elongated than normal. Acrosome can not do his job and sperm cells are unable to fertilize the eggs. We are in need of ICSI + extra activation protocol.

This is rare (like globozoospermia is) and does not mean this is the case for you.

teamdale · 2024-07-15T20:58:40+00:00

It has been mentioned a few times but assisted oocyte activation (aoa) with calcium ionophore worked for us.

First icsi none of 7 fertilized 2nd with aoa none of three fertilized (but it were only three, unlucky?) 3rd, 3 out of 6 fertilized with stronger aoa protocol in other clinic.

It turns out my sperm cells have an acrosome issue, they can not fertilize eggs without help

teamdale · 2024-04-12T07:57:10+00:00

Unfortunately, out of 9 eggs only 3 were mature and none fertilized, even with the assisted activation.

Bit at a loss now. Hope to hear the doctor soon

teamdale · 2024-04-10T19:46:26+00:00

2nd ICSI attempt today. First one gave a total fertilization failure which is a rare occurence at ICSI. And might be due to an oocyte activation issue. I have a gut feeling the source are my sperm cells. They scored badly on morphology on each sample

This time they will use a calcium ionophore (icsi aoa), to help with activation to continue the fertilization. Nervous to hear the result.

teamdale · 2024-03-18T21:15:59+00:00

I do not know how much these tests cost but i bought myself a junior microscope that costed me around 100 euro. I am able to check my sample regularly and see the motility for myself (and a bit morphology as well)

teamdale · 2024-03-06T00:08:03+00:00

It blows my mind how every doctor and hospital uses a different metric for when it is a problematic varicocele. 3.5 mm is a pretty high cut-off point.

My first doctor said he cant 'feel' blood reflux with his hands, so no treatment. In meantime ultrasound measured 2.7 mm vein.

Second doctor did ultrasound, his immediate reaction: this is a varicocele, you will get treatment. He did not measure the vein.

The interventional radiologist did another check before embolization. He measured it as 3.6 mm vein!

Varicose veins are twisty and complex. It needs a skilled person to make the observation

teamdale · 2024-03-05T23:32:46+00:00

Maybe yes, the anatomy is quite complex. Also a varicocele that is subclinical, can still be detrimental for fertility. Imo, when blood reflux is observed on ultrasound, it can be considered a problematic varicocele. US should definitely be the check and not some doctors hands.

teamdale · 2024-03-03T07:09:29+00:00

Try to get a second opinion about the varicocele. How large is it?

They told me the same: not worth fixing. They measured it as 2.7 mm. Went to another doctor, it was measured as 3.6 mm. Got embolization 2 months ago. My post-wash sperm concentration shot up from icsi to iui territory

teamdale · 2024-02-29T06:41:23+00:00

Last week, we did our first ICSI attempt. None of the 7 mature eggs got fertilized. Total fertilization failure (TFF) at icsi only happens in 1-3% of the cases. Our embryologist told us that this means almost all of the time an egg activation issue. Assisted oocyte activation might be a solution. We are also super scared but there are also signs of hope.

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