Embryo arrest at morula - none to transfer
0 Replies
happyfeet - April 15

Hi Dr Smith

My husband and I have just completed our 2nd failed ICSI cycle with pretty awful results, none of our embryos made it to blastocyst. Our primary diagnosis is MFI 5 million per ml count; 10% motility and 6% morphology; 30.2% DNA fragmentation as per SCSA. My husband has low FSH:LH and low normal testosterone. I also have recently discovered that I have one 16mm chocolate cyst on my right ovary and PCO morphology but not the syndrome, I have regular 29 day cycles. I am 27 YO and my husband is 31 YO. Our history is as follows:

Cycle 1
Long protocol, stimmed 8 days 112.5iu Gonal f; upped to 225iu and 150iu alternatively for 5 more days triggered day 13, only 3 eggs collected, 3 eggs fertilised. 2x 8 cell grade 2 (with 1 being the best) and 1 x7 cell grade 2 on day 3. 2 x 8 cells transferred -ve test. Third not frozen.

Cycle 2 (new clinic)
Antagonist protocol, stimming 225iu Menopur 6 days, added in cetrotide day 6; dropped dose to 150iu on day 8, triggered day 10 with lupron due to E2 levels of 16,000. 18 eggs collected, 12 mature, 8 fertilised. All embryos grade 1 on day 3, 2x 8 cells, 2x 7 cells, 1x 6 cells and 3 x5 cells. Embryo growth slowed on day 4, 5 made it to morula stage by day 5, 2 were compacting. When we went for transfer on day 6 they had all arrested.

Our Dr feels that it is potentially an egg and sperm problem. He feels my chocolate cyst may have compromised egg quality but is not sure. He is suggesting egg and sperm donor next time. This is not something we are ready to consider yet.

What is your opinion on what contributed to the embryos arresting? What further tests would you recommend for us? Do you think it is worthwhile trying again with our own eggs / sperm? Do you have an opinion on using PICSI to select chromosomally normal sperm combined with PGD/CGH?

Thanks for taking the time to answer my questions; I really appreciate your advice.

 

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