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Monday, May 30, 2016

Globozoospermia and three precious fertile years wasted !

Question # 3
First of all congratulation on your success story. After reading your blog I though I should contact you and see if you have any insight on our history. Below is a brief history. 
2011 - IVF 22 eggs ICSI used on half (36 female, 35 male)
result: all icsi eggs failed fertilization, some non icsi resulted in polyspermic fertilization
2012 - IVF 15 eggs ICSI used on 2 (37 female, 36 male)
result: all icsi eggs failed fertilization,  2 ferts with IVF and rest polyspermic. normal ferts transferred day 3, no pregnancy.
Protocol on the above cycle:
225 follistim and 75 menapour  days 1-6 
225 follistim and 150 menapour  days 7-11 
HCG trigger on day 12
due to failed fertilization my eggs were blamed and we went on to Donor eggs.
2014 - IVF with ICSI with Donor Egg (6 Frozen eggs from Atlanta, donor has proven history) (Donor AGE 29 with proven donation history, 38 male)
result: none fertilized first day but one slow growing embryo detected the second day with 1PN and  made it to blastycyst, transferred no pregnancy.
2015 - IVF with ICSI using AOA (Artificial Oocyte Activation) -  ( age 41) 
12 Eggs 8 mature 4 fertilization. day 3 all 8 cell embryos,  0 made it to day 5.
following was my protocol.
Decapeptyle  .10            days 1-7
Menopur        300          days 3-15
Menopur        225          days 15-17
AMh: 2.6 (ng/ml)
FSH: 8.5 (iu/ml)
The 2015 cycle with AOA was done as we believed that the sperm was lacking in PLCz protein to activate the egg, this explained to us the polyspermic fertilization we have been receiving and lack of fertilization from ICSI. It seems like the AOA helped to overcome these issues. But our embryo failed to survive to blastocyst stage but were good 8 cells at day 3. do you believe this is an Egg problem or could it still involve an issue with sperm. Not sure what direction we can go from here. Thinking of using donor sperm but I am not even sure about me eggs as well. Very frustrating and disappointing that after so many cycles with still have no clear cut answer. Based on your knowledge what problems do you see in our case.
Nice to hear from you. It is really sad that they took 3 complete years to identify globozoospermia  !  Those three years were precious for your fertility and they were wasted.

I think , before , the problem was the sperms. But now, one more additional factor has come into play - your age and hence egg quality !

But the positive thing is,  you still produce decent number of eggs , and hence stand a good chance of success. Does your IVF clinic perform CCS  -  a technique which is used to identify euploid embryos ? Even though , the efficacy of CCS is still in question for women of advanced maternal age , in your case , it can throw light on the quality of your embryos. But for CCS you need embryos which grows to blastocyst stage !

Your next best option is to go to a clinic which has high success rate for women of your age. 

If you ask whether sperm is the problem, the answer is , yes , it was. But with the help of AOA ( Assisted Oocyte Activation ) , the sperm problem can be overcome. Now , you just have to repeat IVF until you find that one good embryo . It might take several attempts because of your age, or, you might find success in the next attempt, if your are lucky ! A recent study says that the aneuploidy rate can be as high as 90 % in women above 40 years of age.  This means only one out of ten embryos produced using your eggs will be genetically normal !

I wish you lots of good luck in your endeavors !

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