Thank you for your support here first.
Few questions RE) IVF oocytes retrieval
1.) I'm 39yo going to be 40 soon this year AMH 4.44pmol/L
2.) I did my first oocytes retrieval at age of 34. 2 rounds I have got total of 21 oocytes and 19 were mature
3.) Did my first round of IVF last year in Dec: only 4 embryos made it to Day 5 PGTA . One normal XX but XY complex mosaic (46 +5+15-7-9)
** my doctor stated that the sperm motility was poor : 46% pre wash and 100% post wash (?? why)
4.) I did another round of oocyte retrieval in April 2023, got total of 17 occytes, 13 were mature. 8 of them made it to Day 5 PGTA. Still XY complex mosaic/ abnormal
( 46 +14; 45-15, 46+1+15 +X-Y, 46-18)
** this time the sperm motility is dropped from 59% pre wash to 48% post wash ??why again
My questions are
1.) Sperms quality is poor but why motility improves after post wash in the first round
2.) sperm quality is poor still second round? (I have changed my sperm donor already)
3.) I have performed a genetic test on myself and both the sperm donors as well. What happened here why all my XY embryos has problem please?
4.) I have discussed my case with my gynaecologists, they won't recommend using these XY embryos. What should I do to improve it ?
5.) Planing to start all over again in September this year. What else do I need to look for?
I am sick of injecting myself. So wanna give up. So depressed now. Thank you.
Hello Francesac,
I will give some comments for the info you provided, and then I will address your questions in a separate message.
1. Your AMH level of 4.44pmol/L is very good for your age group; that's why you still have a decent number of eggs retrieved last month.
2. You mentioned your 1st oocyte retrieval was at age 34. I am confused about "2 rounds"; so you had 1 time or 2 times of oocyte retrieval? Also, did you have all the 19 mature eggs frozen?
3. I am also confused when you described your first round of IVF in Dec 2022. Did this round in Dec involve an egg retrieval, or you had your frozen eggs from age 34 thawed and fertilized? Also, from the result "one normal XX but XY complex mosaic (46 +5+15-7-9)", this one embryo is not normal at all. Is this result stated differently on the actual PGT report? What about the results for the other 3 embryos?
**Pre wash is when the sperm is in its original state; the assessment is part of the semen analysis. When we "wash", or process the sperm for further use in IUI or IVF, the sperm sample will be undergoing a "wash", or treatment with centrifugation, to concentrate the motile sperm. So it is not unusual to have a post-wash motility of 100%.
4. I am again very lost looking at the results you stated (46 +14; 45-15, 46+1+15 +X-Y, 46-18). Are you trying to show me the results of all 8 embryos that made it to Day5 PGTA, or is this one single result for one of the 8 embryos??
**sperm motility alone is not the only factor causing aneuploidy, or abnormal embryo. Sometimes, even after sperm wash, sperm motility may not improve or even become worse. But for most PGTA cases the lab performs ICSI (IntraCytoplasmic Sperm Injection) to fertilize the eggs, sperm motility is almost irrelevant as long as we can find motile sperm.
I shall attend to your questions in the next reply.
cutecutetown
Hello again Francesac,
1. I have explained what a sperm wash is in my previous reply.
2. You changed your "sperm donor"; do you mean you actually used donor sperm, i.e. sperm samples that are donated from someone who is not your husband or sexual partner, or you simply mean you changed husband/partner? Since you have 2 different sperm donors in the 2 rounds of IVF, sperm motility and/or quality will unlikely be the same.
3. XY are only the sex chromosomes, while you also have 22 pairs of chromosomes. Half of the chromosomes in an embryo come from you and the other half from the sperm donor; so, if either the sperm or the egg does not carry the correct number of chromosomes to begin with, the resulting embryo will not be normal. And even if we start with a correct number, there is still chance for errors during cell divisions of the embryo. The underlying reasons for having such errors are numerous, but the most common one is related to the woman's age.
4. I will not recommend using those abnormal embryos. And it seems that you are only interested in the embryos carrying XY, i.e. you want only male embryo(s)? There is not much you can do to improve because even after you have another sperm donor, your embryos are still aneuploids; so the problem is more likely to be of female origin, and given your age, it is not unreasonable to assume many of your eggs may already be aneuploid to start with.
5. From an optimistic point of view, you have a good AMH level and every time you have a good number of eggs. You may have to undergo a few more IVF than other younger women in order to find a euploid male embryo. Since you are trying to fight against time, and if financially feasible, I will suggest you start your next IVF sooner.
I am curious where you are from and where you did your IVFs. You do not appear to be doing all these in Hong Kong.