Worsening fertilization rate over multiple cycles
I’m struggling to come to terms with our latest ER results and was hoping to see if anyone had some additional insight.
History: I’m 37, going through IVF because of uterine factor infertility (severe Asherman’s, adenomyosis, thin uterine lining, and recurrent fluid in my lining). Most recent AMH was 1.9. My husband’s last SA was in 2024. He has borderline low morphology at 4% but a very high count so they weren’t concerned. DNA fragmentation was normal at 7%.
ER #1 (Oct 2024) - antagonist protocol; ICSI
AFC - unknown
Retrieved - 17
Mature - 12
Fertilized - 11
Day 3 - 10
Blast - 3
PGT - 1
That transfer failed.
*We then switched clinics to one with a better lab.
ER #2 (Mar 2026) - antagonist protocol (luteal start - this was unintentional but the estrogen priming caused me to ovulate on CD3 and we just rolled with it); ICSI + zymot
AFC - 34
Retrieved - 17
Mature - 15
Fertilized - 11
Day 3 - 11
Day 5 blasts - 3 (5aa, 5aa, 5bb)
Day 6 blasts - 2 (5ab, 5bb)
Day 7 blasts - 2 (5cc, 5cc)
Euploid - 2 (d5 5bb and d7 5cc)
*At this point my doctor essentially said that I just have poor egg quality and therefore the goal would be to better synchronize my cohort so we could focus on quantity thereby increasing my euploid rate.
ER #3 (May 2026) - long Lupron protocol; ICSI + zymot + calcium ionophore
AFC - 25
Retrieved - 12
Mature - 9+2
Fertilized - 5+2
Day 3 - 7
I don’t have final blast numbers yet as today is day 3, but I’m just feeling so disheartened by the fertilization rate. This is our lowest fertilization rate despite adding calcium ionophore. I’m obviously also super disappointed in the number retrieved and mature as these are also our lowest numbers to date. The long Lupron protocol was supposed to help my cohort and clearly didn’t have the intended effect.
Am I just doomed to always only retrieve half my AFC? Why didn’t calcium ionophore help in my case? Is there anything more I can do to improve my results? I’m taking all the supplements that are usually recommended (CoQ10, omega 3, vit D, melatonin, NAC, magnesium glycinate).