?? about fertilization and DE's

[kp1212]

After 3 IVF attempts (2 cx'd due to poor response and 1 with - pregnancy), my DH and I decided to go with DE's.  We picked a lovely 30 year old.  She had completed 3 other cycles (thus we were comfortable with her slightly older age).  Of these 3 cycles, the 1st ended in pregnancy (they retrieved 18 mature eggs, ~12 fertilized), the 2nd was negative (the RE changed her meds; only 7 eggs retrieved, don't know the number of mature eggs or fert #) and the 3rd (during which she produced 21 eggs, again unknown how many were fertilized) was a freeze-all because the recipient messed up the meds pre-transfer.  
For our cycle she had a "great" cycle.  At her last appt on 7/16, the measurable follies ranged from 23.5-9.  A total of 24 eggs were retrieved.  We were not told how many of these were mature.  Today, the lab called with the fert report...only 9 fertilized reportedly due to poor sperm morphology.
My DH's (who is now 47) last sperm analysis was in Sept after our failed IVF.  The lab told us that the analysis was good, specifically the morphology.  THe motility was a bit low (33%, though this was up from 15% a year previous).  They planned on using a fresh sperm sample, though had frozen TESA just in case which was retrieved 3 years ago during a vasectomy reversal.  
Questions (sorry this is getting so long!):
1) How could the morphology change so much since September?
2) Why wouldn't the lab use the TESA if the morphology of the fresh was so poor?
3) 9 fertlized eggs seems really low?
4) Are the 9 embryos at high risk of arresting or developing atypically due to the poor morphology?  How much does the sperm/morphology once fertilized factor into the growth and development of the embryo? Since they fertilized, are they considered no more at risk than any embryo?
5) Any thoughts of the possibility of making it to day 5 transfer??
I hope we are jumping to conclusions, but 9 from 24 seems pretty dismal.
THANKS!
KP

[Elaine Brown, MD]

Hi!
My question is did they use ICSI?  That would seem to resolve the morphology issue. I can't answer why they would not have used the frozen sample, or of course why the morphology of this sample was poor.  9 from 24 is not ideal, but then, you probably only want one baby!  What would you do with 24 embryos if you did have them?
The embryos that fertilized should theoretically behave like any other embryo, as once they are fertilized, the sperm and egg fuse.  How they will mature is anyone's guess, but I certainly hope for your sake that they blossom into lovely blasts!
Two thoughts if they don't.  You probably ought to discuss ICSI with your RE if you have not, and you may want to consider a different donor, as sometimes it seems that two people just don't "mix".  There is ALOT about this reproductive technology that we don't know and don't understand yet--and it is not always totally under human control!
Good luck!
Dr B

[kp1212]

As far as I know they did do ICSI (at least they were suppose to).  This is why we are quite concerned, as my understanding is that the ICSI would resolve the morphology issue. If they did do ICSI, I don't understand why more didn't fertilize?  
I will speak to the lab tomorrow and get more details.
Thanks for the feedback,
Krista