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ohbabyoh - August 6th, 2008 1:14 PM

I am currently on my second IVF cycle. In my first cycle, I had 15 eggs retrieved, 14 mature. 10 were allowed to fertilize naturally, only 4 fertilized. The other 4 were ICSI'ed and those 4 fertilized. By Day 3, the best quality embroyos we had were a 5-cell grade B and a 6-cell grade B. These were two that were ICSI'ed. The rest did not survive to freeze and implantation didnt occur.

For the next cycle, they changed my meds that suppress my ovaries b/c the first time they said they had a difficult time getting them started (I had been on Lupron). So for this cycle, I had 16 eggs, only two fertilized. Then, the following day, they ICSI'ed 6 eggs, with four of those fertilizing, but the first two didnt survive. My first question is, will those embryos that were ICSI'ed on the second day have the same chance of implanting as other embryos? And, what are some reasons my eggs are not fertilizing properly? What tests can be done to determine if it's an egg quality problem or a fertilization problem? And what can be done to help if we have to do IVF again? My husband's sperm is good. The number of motile sperm is always high.


ohbabyoh - August 6th, 2008 1:17 PM

Oh, and I should mention, have Factor V Leiden, Factor II Prothrombin, and MTHFR. I am on Lovenox after each infertility treatment. I had a clot in college which I was hospitalized for. I was on heparin in the hospital for 3 days, lovenox for 4 days, and coumidin for 3 months. I have not had a clot since.


B. Jacobs, M. D. - August 6th, 2008 5:28 PM

Most of the time, failed fertilization is a male factor problem. If the ICSI eggs fertilized and produced embryos, that would seem to confirm the speculation about the sper. For more information about semen parameters, please see our web site, <www.texasfertility.com>.
Good luck.

ohbabyoh - August 6th, 2008 5:43 PM

Thank you for your response.

Will those embryos that were ICSI'ed on the second day have the same chance of implanting as other embryos?

Other than sperm quality (which my doctors maintain is not the issue) what could be some reasons my eggs are not fertilizing properly?

What tests can be done to determine the quality of my eggs?

B. Jacobs, M. D. - August 7th, 2008 6:45 AM

We cannot really know the molecular structure of either eggs or sperm. It could be either. Very commonly, the morphology of sperm is not exactly normal, indocating a problem. Unfortunately most labs do not perform adequate assessment of sperm morphology. As far as send day ICSI, the published data imply poor outcomes.
Good luck.

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