100% Polyspermy during IVF - anyone else had this?

[dkt78]

We had our first ultrasound last Thursday at 6w1d and found out we're expecting twins. We've been in shock and a little bit of denial all weekend. The babies measured a little small and both heartbeats were detected but they were only 111 and 113. Still, we've "graduated" and will be moving on to a regular ob/gyn. Our RE suggested we consider going to someone that deals with higher risk patients because of our history and now twins. Hopefully it's not because of the size and heartbeats. Our first appointment is June 4th. We're really looking forward to it to make sure everything is going well. In the mean time, we're trying to figure out just how this is going to work.

Boots8182, how are you doing? Have you started telling people or are you waiting?

Thanks for the well wishes Hopeful76. How's your little girl? And did you used to live in the UK? I noticed your location is now Sydney.

 

[jenn918]

I am 27 years old, my husband and I have been trying to conceive for nearly 3 years. We have had 7 or 8 failed iui cycles and our first heart breaking failed ivf cycle. My husband has been tested and has a great sperm count and quality. I never in a million years thought that there could be something wrong with me ... simply because I am so young and healthy, my family has always been very fertile, there is no history of having trouble conceiving, my dr never indicated that he thought there was an issue. I did lupron, gonal f, menapure, and ovidryl for this ivf cycle. I went in very confident and left just as confident. They were able to retrieve 12 eggs that looked good. I waited by the phone the following day, to hear WHEN we would transfer the embryos. I received the most shocking news that I was completely floored by, my dr was just as dumb founded. Retrieval was 9/19, when they went to check the embryos on 9/20 they found that all 12 eggs has weak shells and instead of the 1 or 2 sperm that typically penetrate the egg, all 12 of my eggs were penetrated by 100+
My dr and the ivf specialist both said they have never seen this before. The ivf specialist said that occasionally he will see 1 or 2 where this happens but never an entire batch. He said that in addition there were some other abnormalities. Basically he suggested the options going fwd are icsi but he is not confident that the results would be any different than they were this time or a donor egg.

i just am floored. I have never felt so lost and broken. I really do not know how or if i will get past this. I cannot fathom that this is it for us. I am only 27 and I just feel like I cannot accept this as the final answer. I have no completely ruled out the idea of alternate options, donor egg, adoption, etc ... but I just am not ready to through in the towel on using my own eggs.

I feel like I am going crazy, I have surfed the internet and this is the closest information I have found to my situation. I am open to ANY ANY ANY advise, suggestions, ideas, anything ...
We are meeting with our dr sometime this week to talk and I really want to be bale to have something to bring to the table.

I have felt completely lost and hopeless ... and sick however this thread has been the first glimmer of hope I have found! I could not be more happy for all the success stories posted...

 

[Briss]

jenn, unfortunately I do not have much experience and do not have advice, just did not want to R&R. Please do not let them bully you into donor eggs. you are young and healthy, I am sure it can be fixed one way or another. I read about other ladies having similar issues and in most cases ICSI helps. from what i gathered possible reasons can include (i) the outer layer of your eggs is faulty - ICSI is a solution; (ii) wrong protocol chosen by the clinic that weakened your eggs - change protocol/clinic. I think in your case it's probably the protocol (although I am no expert I am just thinking out loud here) because ladies with egg issues often get multiple miscarriages with this problem before going for IVF

 

[jenn918]

Briss thank you for replying!! I appreciate any input at this point!! I have been vigorously researching and hope is slowly coming back! The ivf specialist at the clinic said that my situation was so rare that it doesn't even have a name however after spending a few hours online I am confident the situation he explained is indeed Polyspermy. I won't accept this is the final answer ... And I believe your advise is correct and much appreciated! I will not stop ... I am going exhaust all resources, I will go wherever I need to. I will go outside of the states or across the country. Someone has to know some thing!!

 

[Briss]

jenn, best of luck! keep us posted on your progress. I am sure other ladies will share their experience as well.

 

[jenn918]

Thank you!! I will!! Best of luck to you as well!! I am so happy someone replied..

 

[Hopeful76]

Hi Jenn918, just wanted to send you hugs and say that once you feel ready I would definitely say ICSI is worth a try. I'm sure you've read this thread so can see that seems to have worked for us polyspermies . My daughter is now nearly 16 months old and I can tell you I never thought we would have her when we had our polyspermy news but here we are!
Dkt78 my daughter is doing really well and yes we did move from London to Sydney - going on 2 years now since the move!

 

[jenn918]

Hopeful76,
First off congrats on your baby girl!!! And secondly I am ecstatic that you replied! Thank you!

If you do not mind I have a couple more questions. My dr and the embryologist said that my case we so rare, they had never seen this before, and in quote "this is so rare there is not even a name for it." I was floored. They did not give me this diagnosis of having polyspermic fertilization, this is something that I found on my own. They described my situation as followed. My stimulation was text book, they could not have been more happy with my work up and the retrieval. It was not until they went to check my eggs on 9/20 the day after retrieval did they find that 100s of sperm had penetrated the eggs, when typically only a few penetrate. He said that typically the zona pellucida (the shell) is typically really thick, he has that the shell of my eggs were abnormally thin. Is this how your dr explained your situation? There were some other abnormalities he explained but I have not found a possible answer for those yet and too I am wondering if those also stem from the polyspermy??? I have no idea just trying to figure something out

I just am trying to find anything that may be able to support what I have. I cannot accept that my situation is the first time anything like this has happened.

Would you be willing to tell me your doctor and/or embryologist name? Or if you do not want to do that can you tell me the clinic that you given this diagnose at? Did you go back to that same clinic for the ICSI? I see that you are located in Sydney previously in London, I am in The States, however my husband and I have discussed that we will go outside of The States if necessary (and obviously if we are able to afford it) but for now I would like to reach out to any doctor or clinic, present my case and see if this is something they have dealt with and maybe they can confirm my diagnosis. I have
requested my medical chart from my current care provider, so I could possibly have anything it may take to sent to another clinic.

Also, were you advised to take any supplements to make any daily changes to help improve your egg quality?
Thank you again! And I accept and appreciate that hug!! I could not be more happy for you and your child! In addition, I am thankful for the hope that this thread has given me! I will heal from this and I will give ICSI a shot but i want to make sure I am as educated as possible!

 

[Briss]

jenn, one of the questions that I'd have in your situation is whether there is any difference between an egg being penetrated by 2 sperm or by over 100. is it the same issue or is this two completely different scenarios? To me personally it would not make a difference, I cant see how it matters how many sperm were able to get in as long as it's more than 1, it should be treated as the same issue but I am not a specialist so I'd just ask somebody who specialises in this.

 

[jenn918]

Briss, you bring up a good point! I will absolutly look into that and bring it up in my consult!! I agree, obviously I have no medical background on this matter, however "logically" this makes sense?? I would think!

 

[jenn918]

I'm not sure polyspermy is what I have ... Relieved but disappointed! I thought maybe I was on to something but I presented the thought to my dr today and he quickly suggested that he has seen polyspermy before and doesn't believe my case fits the bill.

He suggested that the most pressing concern they found was how extremely fragile my eggs were, and the nature of the frailty. The embryologist sent out a summy if my case to a network of drs across the United States looking for any input he may be able to receive, maybe someone could shed some light on the condition and or offer a suggestion.

Here is his email that was sent out
We had an interesting case last week that I would appreciate your input on. Twelve eggs were retrieved from a 28 y.o. (I am actually 27)patient on her first IVF cycle for unexplained infertility. She had gone through 11 inseminations (wow didn't realize I had done 11 rounds of Iui) prior to moving to IVF. The eggs were inseminated conventionally with 100K sperm per ml of media (our standard). The next morning, when attempting to strip the cumulus from the first few eggs for fertilization check, the zonas cracked and the eggs ruptured or came out of the shell intact. Proceeding with caution, the embryologist picked up / attempted to clean the remaining eggs with a larger pipet and moved them to a fresh dish, with much of the coronal cells still intact. Enough cumulus was removed though that we were able to make some observations. First, the zonas on all but a couple of the eggs appeared very thin and “fragile”, second there was an extraordinary number of sperm bound to the zonas, and even more unusual there were large numbers of sperm moving freely around in the perivitelline space. No pronuclei were identified in any of the eggs, which were a little darker and more granular in appearance than average. Also, there were only a few eggs that had any sort of recognizable polar body, perhaps they were obscured by all the sperm or cells but I felt I got a pretty good look. If you’ve handled a case like this or have any thoughts on the matter I’d appreciate hearing about it.

This all sounds foreign to me, but I'm not giving up hope!! I researched like a mad last all day!! I sent the contents of my situation to tons of clinics hoping maybe someone somewhere as seen this and can give me an answer or suggestion ... Or even a diagnosis !!

So discouraged but hopeful!!

Was anyone advised suggestions to streghten or improve egg quality ?

Thanks all who are reading !!

 

[Hopeful76]

Jenn918, I can't remember the name of our doctor for our polyspermy cycle but we were at Barts and the London (in London). Our doctor had seen it before and was far more relaxed about it than us. He said he'd seen couples go on to have normal fertilisation in later rounds of ivf (in the days before ICSI). He did say it was rare. He said they might see one case of polyspermy a year. If we'd stayed at this clinic their recommended next approach was ICSI. The thing they said with ours was that there was an abnormally large number of sperm adhered to the eggs (and multiple that had penetrated causing abnormal fertilisation). They had no idea what the cause was. Neither they nor our new clinic advised any particular diet or supplementation to try and improve egg quality (aside from normal healthy eating). I did go to a diff clinic in London for an IUI cycle and they had their women on a pint of full cream milk a day during stimulation (extra protein to theoretically support the eggs) and then I'm pretty sure they switched to a glass of pineapple juice a day to assist implantation (don't quote me on that its a while ago now!!). A lot of the women at that clinic used to also see Zita West during their cycles - look her up you can get her books. Our new clinic in Sydney was Genea, the main thing they did (in terms of their estimate in trying to support my eggs as best as possible) was to put me on a short cycle ivf (ie no down regulation and just a couple of weeks max of stims) and put me on a low but consistent dose of stims - and of course they also recommended ICSI.
I hope this provides a bit more info for you! x

 

[jenn918]

Hopeful76 -- you are an angel taking time out of what I am sure is a busy day to reply to me! Thank you!

Did your dr say your eggs were fragile? Or ever suggest that the shell was weak therefore allowing the polyspermy? I asked my dr of he thought it was polyspermy in my case and he said he didn't think so, he said that multiple sperm penetrated due to the extreme frailty of my eggs.

 

[Hopeful76]

Jenn918, my doctors never named a cause because they honestly had no idea. They suggested a possibility that there was something 'wrong' with my eggs but there was no way of testing for that. As far as they have been concerned it is one of those freak things that could be due to any number of factors. The only thing they knew for sure was that too many sperm fertilised my eggs. The only thing they knew they could do to get around that was ICSI. Please try not to play over in your head too much the idea your eggs are 'fragile'. Just remember no one really knows and you are young and healthy and still have lots of time and options. Try and be kind to yourself. Hugs xo

 

[klik]

Not sure anyone will read this post in this old thread, but here goes...

Firstly I wanted to say that I have my fingers crossed for jenn918--were you able to find a way? Are you still looking for one?

Secondly, I wanted to thank Hopeful76, Boots8182, and dkt78 (did I miss anyone??) for posting your experiences and eventual success despite polyspermy. My case has an added twist--I have a low ovarian reserve, so am on a natural cycle protocol. One egg did manage to be retrieved yesterday, but today I got the bad news that it had let 3 sperm in. Who knows if it was just that one egg or if it's how all my eggs are? Embryologist suggested ICSI for next time, so that's what we will try... I'm envious of your multiple eggs on which to try ICSI, but hey, who knows--if I'm lucky, this may explain our infertility (including one natural chemical pregnancy) thus far, and ICSI may well be the solution.

Again, I'm deeply heartened by the success stories, because they mean that eggs that are bad at blocking sperm are not necessarily unable to eventually produce healthy embryos. So thanks again!

And jenn918, I am thinking of you... I really hope you have/are finding a way...


Best to all,

Klik.

 

[Hopeful76]

Hi Klik, bit of a surprise getting a message related to this post but glad it has given you hope. Reading your post did make me think of a book I read on my journey which I found really inspiring. It was called 'inconceivable' and now has a support network fertileheart. The author had low ovarian reserve and researched and made diet and lifestyle changes, her hormone levels got much better and she conceived. Not that I'm suggesting you need to change anything but it might be of interest.
Thanks for your well wishes! My first ICSI is now 3.5 years old and the two frozen embryos we had from that same cycle are now gone. The first was a m/c at 9 weeks but the second gave us another beautiful girl who is now 4 months old. I know we have been very lucky and I'm glad we persisted when I definitely felt ready to give up after the polyspermy.
Wishing you luck and strength on your journey

 

[klik]

Believe it or not this thread is one of the first hits on my search engine when I search for 'polyspermy IVF'!

I am sorry to hear you had to face a miscarriage on your journey, but I send you deep heartfelt congratulations on your two children! Wow, what a result!

Thanks for the book recommendation--I will check it out. I think my diet and lifestyle are "healthy" but there probably are ways to make them more conception-friendly.

But most of all, again, thanks for sharing your story. I can only imagine how disheartening it must have been to have had 16 eggs collected and then to hear the ones that fertilised all suffered polyspermy. Yet here you are!

Wishing you all the best,

Klik.

 

[mikeywhy16]

I just wanted to thank Hopeful76 and the other women who commented on this thread. The posts here were an absolute lifeline for my wife and I when we experienced "polyspermy" or "abnormal fertilization" in Oct 2015. Also, we wanted to share our story to give hope to those in the same situation.

My wife had 18 eggs retrieved for IVF in October 2015. The next day we received the devastating news that all of the eggs fertilized abnormally or that multiple sperm penetrated every egg. The lab actually called our Doctor to come over and take a look at what had happened because neither the lab nor anyone at the hospital had seen it before.

We live in Ontario, Canada and we met with our doctor a few weeks after the failed IVF. By the time we met with him, I had scanned the internet for any similar stories or any articles relating to polyspermy or fertilization. This thread was extremely helpful because we thought at least ICSI was a possible option for us. And there really isn't much else anywhere on this subject. Our doctor told us he had never seen this before and really had no idea what had happened. He suggested it could be an egg problem and that donor eggs may be required. We told him at that point we were not ready to got that route and would like to try ICSI and see what happens. He also told us to feel free to contact other clinics if they could offer better help.

From the articles I had read, my own theory was that all of the eggs retrieved were immature and that they probably were not developed enough yet when they were mixed with the sperm for fertilization. There is a study that shows a correlation between immature eggs and polyspermy. My wife 's follicle drugs were amped up quite a bit from her IUI attempts to grow more follicles for IVF. One article I read had a theory that sometimes there is an asymmetry between follicle and egg. So maybe even though the follicles grew to the size the doctors wanted to see, the egg inside each follicle may not have been as developed. Or the eggs were growing too fast and not developing properly. Or the egg was just slow in activating the sperm block after the first sperm entered.

Back to our story, we moved forward with our IVF ICSI for April 2016. We met with the embryologist at our hospital before going ahead with it just to rule out any rare sperm problems. I also read a lot on Oocyte Egg Activation, and wanted to see if our situation might require this. He was extremely knowledgeable, and said ICSI was our best option. Oocyte Egg Activation was more for a "no fertilization" not "abnormal fertilization". We looked at the lab work from the first IVF and basically every egg had 2 or 3 or 4 sperm in it. I told him my idea that all of the eggs were immature and he said that was a possibility, but there is really no way of knowing that.

Our doctor lowered the dosage for the follicle stimulating hormones for this IVF (Puragon). It resulted in the egg retrieval being a few days later in the cycle. If we had endless amount of money to spend and if egg retrieval was not a painful and terrible experience for my wife, I would have loved to try and fertilize half of the eggs received with regular IVF and the other half with ICSI just to see if it was the drug protocol that caused the 100% Polyspermy in the first IVF. We couldn't take the risk of wasting eggs or money though.

Anyways, 16 eggs were retrieved and all 16 fertilized normally with ICSI. Unbelievably happy news for us.

9 Eggs made it to 5 day Blastocyst. 8 Frozen.
Fresh Cycle-BFN
1st FET- BFN
2nd FET-BFN
Endometrial biopsy done
3rd FET- BFP

I hope this helps anyone that stumbles across this thread. I am not a doctor and a lot of what I posted was just my own speculation. Feel free to contact if you find yourself in the same situation.

Mike

 

[IVF_BELIEVE]

Hi Ladies! It is now 2017 and I am reading your stories and so happy to hear you were successful. In January 2016 my husband and I did our first IVF cycle and we had 31 eggs retrieved all mature and 30 fertilized abnormally with polyspermy. Again, our RE told us it was rare and that they'd never seen it before. I feel like we are our own little community who have experienced this. We are currently in our 2nd cycle and my egg retrieval is tomorrow. We will be doing ICSI and I hope and pray that we are successful. I just wanted to say thank you for lifting my spirits after hearing your stories.

 

[Undantag]

Hi everyone. We also had this happen to us and are obviously very worried about what is going to happen as we move forward with ICSI. This forum is a comforting read and we can only hope to have the same ending as many of you have. If you have any updates or advice, we would be very grateful. Best to all!