I know this is old, but I hope you are still on here and might see this. I've been through the wringer of IVF with 10+yrs of infertility. I can tell you that unfortunately IVF docs do NOT have all the answers, just educated guesses at best. If it is mitochondrial damage (not likely but possible) then consider adding the following supplements - CoQ10, PQQ, Niagen, and Pterostilbene (all can be found on Amazon). Oddly enough mito issues are actually pretty easy to fix if it's just from the stress of the weight loss surgery. If it's an inherited issue then unfortunately no amount of supplements will help.