Insight on poor blasts and autoimmunity?

Hi everyone. I just turned 40 this year, AMH in the 2.7 range. I have Hashimoto’s Thyroiditis and have tested positive for rheumatoid arthritis, so there’s def some autoimmune issues going on. I had three back to back failed IUIs two years ago. I started my 1st IVF cycle in April, primed with BC for two weeks, with 300 Gonal, 75 Menopur, 10 mg Provera, and dual triggered with Leuprolide and Novarel. With ICSI, had 6 eggs retrieved, 4 fertilized, and 3 only made it to day 3, and one of them was an early blast but with poor grading so we didn’t go through with a transfer.

Started with a new clinic two months ago, and the protocol was similar, but dosage for Gonal was increased to 350, 75 Menopur, 10 Provera, and triggered only with Pregnyl, and surprisingly (but not surprisingly?), had very similar results with conventional IVF—6 eggs, 4 retrieved, 3 that were very slow to progress and had made it to day 5, but only had one turn into a morula on day 6, and a poor blast on day 7 (today) which couldn’t be graded. 🥺

I don’t know where to go from here. My wife (32) has never wanted to be pregnant, but she is wiling to do so for us, although I always wanted to have the experience of being pregnant and birthing our child. I understand being older it is to be suspected, but if there’s anyone here that could share their experience if you’ve been in a similar situation (embryos slow to grow or not making it to day 5) that have underlying autoimmune issues that has impacted egg quality and what protocols you’ve tried, I would greatly appreciate it.

I also wanted to thank everyone that is on this forum. Since I started the IVF process in April, it has been one of the most isolating experiences I’ve ever had, and this community has been the greatest support to me during this entire process.