Question: Myself (aged 35 years, wt 65 kg) and spouse (aged 31 years, wt 59 kg) trying to conceive from May 2012.
Self - Semen analysis : normal motility and count. Sperm agglutination was noted. Taking Zevit, Celin and Lycopene tablets.
Spouse - PCOS with antral follicle count 16 was indicated in May 2012 follicular scan. Tried conceiving naturally for 1 year while Spouse was taking Metformin and Ovacare tablet. Post May 2013, 2 cycles of timed intercourse were tried with ovulation induction by Metformin, Ovacare and Clomid. No success. 2 IUIs performed in Dec 2013 and early 2014 with ovulation induction using Metformin, Clomid and HCG. No success. Performed Diagnostic laproscopy - results showed mild tubal factor with peritoneal endometriosis. Endometrial TBPCR normal, Uterus normal. 2 insignificant fibroids noted. Some laproscopic corrections made. Doctor recommended IVF and also gave Lupron injection.
Next cycle Day 2 scan results: very mild PCOS, no day 2 cyst. Proceeded for IVF1. Metformin was stopped, Ovacare and Ecosprin oral medication given.
IVF 1(April 2014): Injections for follicular growth(Day 2 till Day 13). Day2 follicle count: 11. Retrieved eggs: 10. 8 fertilized (50% natural fertilized,50% ICSI), Day 5 1 Blastocyst C grade and 1 early blastocyst transferred. No embryos to freeze. E2 and progesterone levels normal. Progesterone support given after embryo transfer. Results- No success.
Spouse was advised to take Ovacare + Ecosprin + Ovares (Dhea) 75 mg daily for 2 months (June and July 2014).
IVF2 (August 2014): Day 2. Scan showed no PCOS, normal endometrium, 8 antral follicles. Protocol antagonist(day 2 to day 11). Ovares stopped. Retrieved eggs: 5 mature eggs. All eggs were fertilised with ICSI due to low egg count. Day 3 : 3 Grade B embryos (one 8 cell, one 10 cell and one 11 cell) transferred. Post transfer HCG injections and progesterone support given. Result - No success.
Now advised for Self - Sperm DNA fragmentation test and Spouse - Continuing Ovares (DHEA) for 3 months.
Request your opinion on available treatment options.