low fertilization rate
6 Replies
LS2005 - August 17

Age 29 Dx Male Factor
Just found out my fertilization results from 2nd IVF: 3 fertilized out of 11. Ist IVF 5 fertilized of 15. Pretty much the same fertilization rate.
The eggs look great visually. I am a good responder with normal FSH. It doesn't seem to be a lab issue. Since we have male factor- low morph, motility and count. Is this most likely the reason for our low fertilization rate?


B. Jacobs, M. D. - August 17

A properly performed assessment of sperm morphology correlates well with the ability of sperm to fertilize eggs. If there is a significant morphology problem, it may be necessary to inject sperm into eggs (ICSI) to achieve fertilization.
Good luck.


LS2005 - August 17

Both of these cycles were with IVF/ICSI. Do you think it is an egg problem. or a sperm problem?


LS2005 - August 17

From what I have read....fertilization does not appear to be adversely affected when sperm is abnormal as long as ICSI is performed. The egg does not appear to care if the sperm carries a genome with fragmented DNA or not. Does this mean it is due to my eggs even though the reason we arrived at IVF/ICSI was due to my husbands low sperm, low morph, low motility?


B. Jacobs, M. D. - August 18

When fertilization does not take place, after ICSI, there seems to be a problem with the ability of the chromosomes of the sperm to change fro their very densly packed configuration into a looser arrangement. Therefore, chromosomes from the sperm are unable to pair with chromosomes from the egg, and there is no fertilization.


LS2005 - September 7

thanks for your response, do you think an egg maturation problem could be the issue? I asked Dr. Smith the same question and he thinks it could be inadequate cytoplasmic maturation. Borderline mature eggs - mature enough to ICSI, not mature enough to activate? He thinks this especially if we had follicular disynchrony. (not sure if we did or not but will find this out) I think I had the same amount of follicles for both cycles. About 26 follicles total if that info helps. I will find out the sizes and let you know.
Here is my E2 levels if that helps:
pre-stimm E2=9
stimm day 5= 155
stimm day 7=759
stimm day 9=1804
stimm day 10=2785
trigger day= 3288
E2 levels were very similar both cycles. 19 eggs retrieved first cycle (15 mature) 5 fertilized. second cycle 11 retrieved, 11 mature, 3 fertilized.

He thinks I should stay on the same protocol but stimm longer? I stimmed for 10 days (trigger on day 11) and was on long lupron with 225 units follistim for both cycles with same fertilization results. Slightly slow embies both times with average quality.
From what I have researched, it seems like there is some sort of egg maturation issue. Normally, even with low sperm counts we should get at least 50% fertilization. Nothing points to an egg issue. So it makes sense that it could be an egg maturation issue. Do you think so? What would you change?
I am working on some second opinions and still need to meet with my RE regarding this cycle. Any input you have would be great....
thanks so much!
also FYI: my DH's sperm numbers are about 10-20 million/ml 10-30% motile and 1-5% morph.


B. Jacobs, M. D. - September 7

Your estrogen rise was a little rapid in the beginning, and that could produce some dysychrony of maturation of egg nucleus and cytoplasm. It would be improper fro me to try to second guess your RE. I do not use estradiol levels to determine when to give hCG. I use follicle measurements. Sometimes the estradiol level will make me determine not to give hCG.
Good luck.



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